Individual
ELIZABETH ALEXANDRA GOODMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
80 SEYMOUR STREET, HARTFORD HOSPITAL ORTHOPEDIC DEPT, HARTFORD, CT 06102-5037
(860) 545-2245
Mailing address
P.O. BOX 415933, HARTFORD HOSPITAL PROFESSIONAL SERVICES, BOSTON, MA 02241-5933
(860) 545-7602
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
002315
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003023157
—
CT
Enumeration date
09/04/2009
Last updated
04/12/2012
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