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Individual
JONATHAN ANDREW GODFREY
Active
Individual
JONATHAN ANDREW GODFREY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA C
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
25MP00042500
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1038807
NCCPA
—
01
—
25MP00042500
NJ STATE LICENSE
NJ
Enumeration date
02/09/2006
Last updated
02/16/2023
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