Individual
JOSHUA SCACCIA GOODMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
5989 BIG TREE RD STE A, LAKEVILLE, NY 14480-9719
(585) 346-4460
Mailing address
5989 BIG TREE RD STE A, LAKEVILLE, NY 14480-9719
(585) 346-4460
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
029399
NY
Other
Enumeration date
03/09/2023
Last updated
05/04/2025
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