Individual
GAIL R GOODMAN
Active
Individual
GAIL R GOODMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
194330
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00010065904
UNIVERA
NY
01
—
000524370006
BC/BS
NY
05
—
01477605
—
NY
01
—
040426002662
FIDELIS
NY
01
—
1211151
IHA
NY
01
—
147716DL
PREFERRED CARE
NY
01
—
479993
WELLCARE
NY
Enumeration date
01/18/2006
Last updated
08/26/2014
Update your record
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