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NPI Code Detail

MEDICARE: DR. WARREN HARVEY GOODMAN MD

MEDICARE:  DR. WARREN HARVEY GOODMAN  MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12084P0800XPsychiatry Physician084220NY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1063595528
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. WARREN HARVEY GOODMAN MD
Provider Business Mailing Address
First Line : 1 BARSTOW ROAD
Second Line : SUITE P 14
City : GREAT NECK
State : NY
Zip : 11021-3501
Country : US
Telephone Number : 516-487-1484
Fax Number : 516-487-7804
Provider Business Practice Location Address
First Line : 1 BARSTOW ROAD
Second Line : SUITE P 14
City : GREAT NECK
State : NY
Zip : 11021-3501
Country : US
Telephone Number : 516-487-1484
Fax Number : 516-487-7804
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/20/2006
Last Update Date : 07/08/2007

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