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General NPI Number Information
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NPI Number | 1013213834
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Entity Type | Organization
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Legal Business Name | DAVID J. GOODKIND, MD, PC
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Dates
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Enumeration Date | 01/27/2011
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Last Update Date | 01/27/2011
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Provider Practice Location Address
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Address Line | 2 CHESTNUT ST
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City | BRANFORD
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State | CT
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Zip | 06405-3796
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Country | US
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Telephone | 203-871-3799
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Fax | 203-646-9719
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Provider Business Mailing Address
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Address Line | 2 CHESTNUT ST
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City | BRANFORD
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State | CT
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Zip | 06405-3796
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Country | US
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Telephone | 203-871-3799
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Fax | 203-646-9719
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Authorized Official
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Title or Position | OWNER
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Name | DR. DAVID J GOODKIND
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Credential | M.D.
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Telephone | 203-871-3799
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2086S0122X
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Taxonomy Name | Plastic and Reconstructive Surgery Physician
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License Number | 024179
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License Number State | CT
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