Individual
FREDERICK GREG GOODRICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
260 W MAIN ST, STE 7, BAYSHORE, NY 11706
(631) 665-3768
(631) 665-3768
Mailing address
260 W MAIN ST, STE 7, BAYSHORE, NY 11706
(631) 665-3768
(631) 665-3768
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
08100
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00918332
—
NY
Enumeration date
12/11/2006
Last updated
07/08/2007
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