Organization
PEDIATRIC GASTROENTEROLOGY AND NUTRITION GROUP, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SUSAN P GOODE M.D (PRESIDENT)
(347) 327-3874
Entity
Organization
Contact information
Practice address
3640 MAIN ST, SUITE 204, SPRINGFIELD, MA 01107-1145
(413) 304-2650
Mailing address
3640 MAIN ST, SUITE 204, SPRINGFIELD, MA 01107-1145
(413) 304-2650
Taxonomy
Speciality
Code
Description
License number
State
2080P0206X
Pediatric Gastroenterology Physician
Primary
233855
MA
Other
Enumeration date
06/25/2010
Last updated
06/25/2010
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