Individual
STEPHANIE L GOODWIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
310 TAUGHANNOCK BLVD, 4TH FLOOR, ITHACA, NY 14850-3251
(607) 269-0100
(607) 269-0140
Mailing address
310 TAUGHANNOCK BLVD, 4TH FLOOR, ITHACA, NY 14850-3251
(607) 269-0100
(607) 269-0140
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
C2-0008116
DE
207RI0011X
Interventional Cardiology Physician
Primary
C2-0008116
DE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010105340
—
VA
Enumeration date
02/22/2006
Last updated
10/20/2010
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