Goodenough, Elliot

Goodenough, Elliot is an individual health care provider with primary practice located at 1427 Vine St , Philadelphia PA 19102-1031. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Goodenough, Elliot can be contacted via phone (215) 762-2530.

Contact Information

Primary practice address
1427 Vine St Philadelphia PA 19102-1031
Phone: (215) 762-2530
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X MD460791 Pennsylvania

Profile Details

NPI number 1871973313
LBN Legal business name Goodenough, Elliot
Credentials MD, PHD
Entity Individual
Sole proprietor 1 No
Enumeration date May 30th, 2015
Last updated Apr 16th, 2020 - about 6 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1871973313 NPPES
Pennsylvania MEDICAID 103315777

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