Goff, Kathleen M
Goff, Kathleen M is an individual health care provider with primary practice located at 4900 Broad Rd Cgh Pob Suite 2V, Syracuse NY 13215-2265. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Goff, Kathleen M can be contacted via phone (315) 492-5005.Contact Information
Primary practice address
4900 Broad Rd Cgh Pob Suite 2V
Syracuse NY 13215-2265
Phone: (315) 492-5005
Fax: (315) 492-5324
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Family | 363LF0000X | F330961 | New York |
Profile Details
| NPI number | 1194711911 |
|---|---|
| LBN Legal business name | Goff, Kathleen M |
| Credentials | Nurse Practitioner (NP) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Sep 27th, 2005 |
| Last updated | Aug 13th, 2008 - about 18 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1194711911 | NPPES |
| New York | MEDICAID | 02197771 |
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