Doctor Name: | LEONARD JAMES GOOD |
NPI Number: | 1417014911 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MD |
License Number: | 148707 |
Business Practice Address: | 1077 Northern Blvd Leonard J Good Md Po Roslyn, NY - 11576 |
Business Phone Number: | 5163655500 |
Business Fax Number: | 5168696946 |
Mailing Address: | 1077 Northern Blvd, ROSLYN |
State: | NY |
Postal Code: | 11576 |
Phone Number: | 5163655500 |
Fax Number: | 5168696946 |
NPI Enumeration Date: | 01/03/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 148707 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |