Individual
ELLEN GOODWATER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
357 GENESEE ST, SUITE 2, ONEIDA, NY 13421-2658
(315) 363-2123
(315) 363-4651
Mailing address
357 GENESEE ST STE 2, ONEIDA, NY 13421-2658
(315) 363-2123
(315) 363-2821
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
F331906
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02508276
—
NY
Enumeration date
08/07/2006
Last updated
09/03/2019
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