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NPI Code Detail

MEDICARE: AMY GOODWIN

MEDICARE: AMY GOODWIN
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
1163W00000XRegistered NurseRN2279677MA

General Provider Information

NPI Number : 1417882085
Entity Type Code : Individual
Provider Name (Legal Business Name) : AMY GOODWIN
Provider Business Mailing Address
First Line : 305 SALEM ST APT 108
Second Line :
City : WOBURN
State : MA
Zip : 01801-2701
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1493 CAMBRIDGE ST
Second Line :
City : CAMBRIDGE
State : MA
Zip : 02139-1047
Country : US
Telephone Number : 617-665-1000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/16/2026
Last Update Date : 06/16/2026

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Directions to “ AMY GOODWIN ” Practice Location

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