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General NPI Number Information
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NPI Number | 1124343611
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Entity Type | Organization
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Legal Business Name | BERNEY GOODMAN, M.D., P.C.
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Dates
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Enumeration Date | 03/29/2010
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Last Update Date | 03/29/2010
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Provider Practice Location Address
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Address Line | 215 E 77TH ST
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City | NEW YORK
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State | NY
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Zip | 10075-2059
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Country | US
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Telephone | 212-535-0111
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Fax |
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Provider Business Mailing Address
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Address Line | 215 E 77TH ST
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City | NEW YORK
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State | NY
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Zip | 10075-2059
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Country | US
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Telephone | 212-535-0111
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. BERNEY GOODMAN
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Credential | M.D.
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Telephone | 212-535-0111
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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