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General NPI Number Information
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NPI Number | 1386786457
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Entity Type | Organization
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Legal Business Name | LARRY I. GOOD, M.D. , P.C.
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Dates
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Enumeration Date | 02/13/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 176 N VILLAGE AVE
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City | ROCKVILLE CENTRE
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State | NY
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Zip | 11570-3800
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Country | US
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Telephone | 516-766-0300
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Fax | 516-766-2444
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Provider Business Mailing Address
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Address Line | 176 N VILLAGE AVE
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City | ROCKVILLE CENTRE
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State | NY
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Zip | 11570-3800
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Country | US
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Telephone | 516-766-0300
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Fax | 516-766-2444
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Authorized Official
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Title or Position | PRESIDENT
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Name | LARRY I GOOD
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Credential | M.D.
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Telephone | 516-766-0300
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | 134286
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License Number State | NY
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