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General NPI Number Information
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NPI Number | 1366145476
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Entity Type | Individual
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Provider Name | JOSEPH PATRICK GOODROW MSW
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Gender | Male
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Dates
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Enumeration Date | 03/27/2023
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Last Update Date | 05/25/2023
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Provider Practice Location Address
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Address Line | MALONE BEHAVIORAL HEALTH URGENT CARE 125 FINNEY BLVD
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City | MALONE
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State | NY
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Zip | 12953
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Country | US
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Telephone | 518-483-1251
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Fax |
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Provider Business Mailing Address
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Address Line | MALONE BEHAVIORAL HEALTH URGENT CARE 125 FINNEY BLVD
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City | MALONE
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State | NY
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Zip | 12953
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Country | US
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Telephone |
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number |
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License Number State | NY
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