Individual
MR. LANCE GOODMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
R.PH
Contact information
Practice address
462 1ST AVE, NEW YORK, NY 10016-9196
(212) 562-3605
(212) 562-2260
Mailing address
21 HOLLY DR, SYOSSET, NY 11791-5719
(646) 210-3741
Taxonomy
Speciality
Code
Description
License number
State
282N00000X
General Acute Care Hospital
Primary
029503-1
NY
Other
Enumeration date
10/20/2015
Last updated
10/20/2015
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