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Contact Information

JACK GOODMAN, MD
9 LIVINGSTON ST
STE 5
POUGHKEEPSIE, NY12601
 Phone: 845-454-0415
 Fax: 845-454-0914
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Neurological Surgery

207T00000X 02 Physician/General Surgery
Indicates primary specialty

NPI Profile & details for JACK GOODMAN · (Male)

NPI # 1831292051
Status Active
Credentials MD
Entity Individual
Enumeration date 09/06/2006
Last updated 09/04/2012 - About 14 years ago
Sole proprietor 1 No
Identifiers
  • NY License # 86055
  • Other C13377 RAILROAD MEDICARE
  • NY Other 147049 MVP
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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