Individual
DR. KENNETH GOODMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
100 PORT WASHINGTON BLVD, ROSLYN, NY 11576-1353
(516) 562-6510
Mailing address
PO BOX 30301, STATEN ISLAND, NY 10303-0301
(516) 562-6510
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
117490
NY
Other
Enumeration date
07/31/2006
Last updated
11/19/2010
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