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General NPI Number Information
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NPI Number | 1053662114
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Entity Type | Individual
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Provider Name | MS. BERNADETTE FRANCIS GOFF
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Gender | Female
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Dates
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Enumeration Date | 09/28/2012
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Last Update Date | 09/28/2012
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Provider Practice Location Address
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Address Line | 3 ROETHAL DR
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City | HOPEWELL JCT
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State | NY
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Zip | 12533-5854
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Country | US
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Telephone | 845-897-1788
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Fax |
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Provider Business Mailing Address
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Address Line | 249 JOHNSON RD
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City | WINGDALE
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State | NY
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Zip | 12594-1836
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Country | US
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Telephone | 845-551-1528
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 509751111
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License Number State | NY
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