Individual
WARREN J GOODMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.P.M.
Contact information
Practice address
83 MAIDEN LN FL 6, NEW YORK, NY 10038-4812
(212) 780-2378
Mailing address
906 CRANFORD AVE, VALLEY STREAM, NY 11581-3114
(516) 791-5701
Taxonomy
Speciality
Code
Description
License number
State
213EP1101X
Primary Podiatric Medicine Podiatrist
Primary
003926
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00904201
—
NY
Enumeration date
08/12/2006
Last updated
09/15/2010
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