Individual
MR. JOHN GOODFRIEND
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4 DURR ROAD, JEFFERSONVILLE, NY 12748
(845) 428-1678
Mailing address
PO BOX 678, JEFFERSONVILLE, NY 12748-0678
(845) 428-1678
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
993386984
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04564518
—
NY
Enumeration date
08/21/2017
Last updated
08/21/2017
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