Individual
MS. SANDRA WALTER GOODMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
111 EAST 210TH STREET, BRONX, NY 10467
(718) 920-8215
(718) 547-2902
Mailing address
111 E 210TH ST, BRONX, NY 10467-2401
(718) 920-8215
(718) 547-2902
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
F302161
NY
Other
Enumeration date
12/08/2006
Last updated
12/29/2014
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