Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207K00000X | Allergist & Immunologist | 165206 | NY |
N | 207K00000X | Allergist & Immunologist | MA52824 | NJ |
N | 207RA0201X | Internist - Allergy & Immunology | 165206 | NY |
N | 207RA0201X | Internist - Allergy & Immunology | 25MA5282400 | NJ |
NPI | 1447255351 |
---|---|
Provider Name | Dr. Alan Jay Goodman |
First Address | New York, NY 10028-7514 |
Second Address | New York, NY 10028-7514 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/06/2005 |
Last Update Date | 29/01/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
A62343 | (02) |