Organization
UPPER DELAWARE VALLEY INFECTIOUS DISEASES,PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GARY R. GOOD M.D. (PRESIDENT)
(845) 794-6813
Entity
Organization
Contact information
Practice address
427 BROADWAY, SUITE 1, MONTICELLO, NY 12701-1742
(845) 794-6813
(845) 794-6816
Mailing address
427 BROADWAY, SUITE 1, MONTICELLO, NY 12701-1742
(845) 794-6813
(845) 794-6816
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01518258
—
NY
Enumeration date
10/20/2009
Last updated
10/20/2009
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