Individual
HENRY G. GODFREY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1919 MADISON AVE, NEW YORK, NY 10035-2745
(212) 987-1777
(212) 987-1776
Mailing address
20-01 MAPLE AVE, FAIR LAWN, NJ 07410-1523
(201) 791-8088
(201) 791-2202
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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