Healthcare Provider Details

I. General information

NPI: 1093908774
Provider Name (Legal Business Name): ANTHONY EDMUND GOOD DNP, CRNP, RN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/24/2007
Last Update Date: 07/07/2021
Certification Date: 07/07/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

372 N CRAIG ST STE 101
PITTSBURGH PA
15213-1245
US

IV. Provider business mailing address

840 CALIFORNIA AVE
AVALON PA
15202-2706
US

V. Phone/Fax

Practice location:
  • Phone: 412-683-1278
  • Fax: 412-683-6992
Mailing address:
  • Phone: 320-309-9880
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberSP010340
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number200700421322
License Number StateMN
# 3
Primary TaxonomyN
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License NumberSP010341
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: