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NPI Code Detail

MEDICARE: MARILYN B GOFF CRNA

MEDICARE: MARILYN B GOFF CRNA
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
1367500000XCertified Registered Nurse Anesthetist123483MA

General Provider Information

NPI Number : 1225039795
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARILYN B GOFF CRNA
Provider Business Mailing Address
First Line : 37 NICHOLS ST
Second Line :
City : REHOBOTH
State : MA
Zip : 02769-2241
Country : US
Telephone Number : 508-252-4482
Fax Number :
Provider Business Practice Location Address
First Line : 211 PARK ST
Second Line :
City : ATTLEBORO
State : MA
Zip : 02703-3143
Country : US
Telephone Number : 508-236-7430
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/09/2005
Last Update Date : 07/08/2007

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