Individual
ISAAC GOODMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
27 PARK ST, PHS PROVIDER ENROLLMENT, HYANNIS, MA 02601
(508) 862-5981
Mailing address
27 PARK ST, PHS PROVIDER ENROLLMENT, HYANNIS, MA 02601-6666
(508) 862-5981
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
010886-1
NY
363A00000X
Physician Assistant
Primary
2823
NH
363A00000X
Physician Assistant
PA2016-0053
NM
363A00000X
Physician Assistant
PA4312
MA
363A00000X
Physician Assistant
ZS11047635M
IN
Other
Enumeration date
08/12/2006
Last updated
02/12/2025
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