Goodman, Kristy A

Goodman, Kristy A is an individual health care provider with primary practice located at 709 Hawkins Ave Ste 1 , Lake Ronkonkoma NY 11779-2293. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist, which is considered as her primary health care specialty. Goodman, Kristy A can be contacted via phone (631) 467-4221.

Contact Information

Primary practice address
709 Hawkins Ave Ste 1 Lake Ronkonkoma NY 11779-2293
Phone: (631) 467-4221
Fax: (631) 467-4233
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist 225100000X 026489 New York

Profile Details

NPI number 1396804449
LBN Legal business name Goodman, Kristy A
Credentials Physical Therapist (PT)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 6th, 2006
Last updated Jul 8th, 2007 - about 19 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 1396804449 NPPES
New York Other 026489 LICENSE

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