Individual
HENRY G. GODFREY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
130605
NY
2086X0206X
Surgical Oncology Physician
130605
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00622904
—
NY
01
—
51A111
EMPIRE BLUE CROSS BLUE SH
NY
Enumeration date
12/28/2005
Last updated
01/07/2008
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