Individual
MR. JOSHUA W GOODSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
1111 STARK ST, UTICA, NY 13502-4454
(315) 724-8603
Mailing address
1111 STARK ST, UTICA, NY 13502-4454
(315) 724-8603
Taxonomy
Speciality
Code
Description
License number
State
163WG0000X
General Practice Registered Nurse
476476-1
NY
163WH0200X
Home Health Registered Nurse
Primary
476476-1
NY
163WP0200X
Pediatric Registered Nurse
476476-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01709282
—
NY
Enumeration date
05/13/2007
Last updated
08/27/2009
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