Individual
NICOLE GOETZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
N.P.
Contact information
Practice address
161 FORT WASHINGTON AVE, NEW YORK, NY 10032-3729
(212) 305-9800
Mailing address
161 FORT WASHINGTON AVE, NEW YORK, NY 10032-3729
(212) 305-9800
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
331630
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02593153
—
NY
Enumeration date
11/08/2006
Last updated
07/08/2007
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