Individual
DR. IRMA G GODOY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DPM
Contact information
Practice address
612 ALPS RD, WAYNE, NJ 07470-3904
(973) 832-4061
(973) 832-4062
Mailing address
612 ALPS RD, WAYNE, NJ 07470-3904
(973) 832-4061
(973) 832-4062
Taxonomy
Speciality
Code
Description
License number
State
213ES0131X
Foot Surgery Podiatrist
Primary
25MD00295200
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
136309CX9
GROUP MEMBER PTAN
NJ
01
—
136309ZBJF
GROUP MEMBER PTAN
NJ
Enumeration date
04/04/2008
Last updated
06/08/2012
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