Individual
JAY GOODMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4805 GARRISON BLVD, BALTIMORE, MD 21215-5695
(443) 869-2600
Mailing address
4221 TOWANDA AVE, BALTIMORE, MD 21215-6626
(443) 814-3598
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
05/13/2025
Last updated
05/13/2025
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