Glen K Goodman, MD
Ophthalmology in Waterbury, Connecticut
1043218159- Practice location
- 87 Grandview Ave, Waterbury, CT 06708-2514
- Phone
- 203-574-2020
- Fax
- —
- Last updated
- November 3, 2021
Glen K Goodman is an Ophthalmology based in Waterbury, CT. Glen K Goodman practices in Waterbury, CT and has the professional credentials of MD. The NPI Number for Glen K Goodman is 1043218159 and holds a License No. 46944 (MA). The current practice location address for Glen K Goodman is 87 Grandview Ave, Waterbury, CT 06708-2514 and can be reached out via phone at 203-574-2020.
Provider Profile Details
- NPI Number
- 1043218159
- Provider Name
- Glen K Goodman
- Credential
- MD
- Provider Entity Type
- Individual
- Gender
- Male
- Address
- 87 Grandview Ave, Waterbury, CT 06708-2514
- Phone Number
- 203-574-2020
- Primary Taxonomy
- Ophthalmology · 207W00000X
- Sole Proprietor
- No
- Provider Enumeration Date
- July 12, 2005
- Last Update Date
- November 3, 2021
- Certification Date
- November 3, 2021
- NPI Status
- Active
Provider Business Practice Location Address Details
- Address
- 87 Grandview Ave
Waterbury, CT 06708-2514 - City
- Waterbury
- State
- Connecticut
- Zip
- 06708-2514
- Phone Number
- 203-574-2020
Provider Business Mailing Address Details
- Address
- 87 Grandview Ave
Waterbury, CT 06708-2514 - City
- Waterbury
- State
- CT
- Zip
- 06708-2514
- Phone Number
- 203-574-2020
License Information
- License Number (1)
- 46944
- License State (1)
- MA
- Taxonomy (1)
- Ophthalmology · 207W00000X
- License Number (2)
- 67111
- License State (2)
- CT
- Taxonomy (2)
- Ophthalmology · 207W00000X · Primary
Legacy Identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| No legacy identifiers (Medicaid, Medicare or plan IDs) are on file for this provider. | |||
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Frequently Asked Questions
What is the NPI number of Glen K Goodman, MD?
The NPI number of Glen K Goodman, MD is 1043218159. It was assigned on July 12, 2005 and is currently active in the NPPES registry.
What is the specialty of Glen K Goodman, MD?
Glen K Goodman, MD is registered under the primary taxonomy Ophthalmology (code 207W00000X), licensed in MA under license number 46944.
Where does Glen K Goodman, MD practice?
The practice location is 87 Grandview Ave, Waterbury, CT 06708-2514. The office can be reached at 203-574-2020 (phone).
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). It is used in HIPAA standard transactions.
How do I verify this NPI record?
This record is sourced from the public NPPES NPI Registry maintained by CMS. You can confirm it by searching NPI 1043218159 directly on the NPPES registry website.