Individual
TYRONE GOODSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRPA
Contact information
Practice address
69 LINWOOD AVE, BUFFALO, NY 14209-2203
(716) 424-0021
Mailing address
69 LINWOOD AVE, BUFFALO, NY 14209-2203
(716) 424-0021
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
5123
NY
Other
Enumeration date
07/13/2021
Last updated
07/13/2021
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