Healthcare Provider Details

I. General information

NPI: 1891690921
Provider Name (Legal Business Name): CHANA GOODE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/09/2026
Last Update Date: 10/09/2026
Certification Date: 10/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2333 MORRIS AVE
UNION NJ
07083-5714
US

IV. Provider business mailing address

39 FOREST DR
JACKSON NJ
08527-1503
US

V. Phone/Fax

Practice location:
  • Phone: 908-291-2727
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: