Individual
MRS. CHRISTINE E GOUDREAU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
150 PIKE ST, PORT JERVIS, NY 12771-1867
(845) 800-5974
Mailing address
15 SUFFERN PL STE A, SUFFERN, NY 10901-5566
(845) 357-4500
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
645798-01
NY
225200000X
Physical Therapy Assistant
003470-1
NY
Other
Enumeration date
05/26/2011
Last updated
11/24/2025
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