Individual
MRS. MARY E. GOODACRE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.A., CCCA
Contact information
Practice address
11 RALPH PL STE 308, STATEN ISLAND, NY 10304-4419
(718) 981-6020
(718) 876-8370
Mailing address
11 RALPH PL STE 308, STATEN ISLAND, NY 10304-4419
(718) 981-6020
(718) 876-8370
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
603
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02148901
—
NY
Enumeration date
10/31/2006
Last updated
07/09/2007
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