Organization Active NPI

Henry G. Godfrey, M.D., P.C.

  • Surgery Physician
  • New York, NY
National Provider Identifier
1003004706
Registry record updated Dec 24, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
130605 Issued in NY
Legal business name
HENRY G. GODFREY, M.D., P.C.
Practice address
1919 Madison Ave
New York, NY 10035-2745
Phone
(212) 987-1777
Fax
(212) 987-1776
NPI assigned
Oct 9, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 24, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Henry G Godfrey, M.D.
Title
President/Owner
Phone
(212) 987-1777

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208600000X 130605 NY Primary

Addresses

Primary practice location

1919 Madison Ave
New York, NY 10035-2745

Mailing address

20-01 Maple Ave
Fair Lawn, NJ 07410-1523
Phone (201) 791-8088

Other identifiers 2

IdentifierTypeStateIssuer
0833HOtherNYEMPIRE BLUE CROSS BLUE SH
00622904MedicaidNY

National Provider Directory

National Provider Directory

Locations

1919 Madison Ave
Frnt 2
New York, NY 10035
Phone (212) 987-1777

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1191888000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1450915200000",
    "number": "1003004706",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20-01 MAPLE AVE",
            "city": "FAIR LAWN",
            "state": "NJ",
            "postal_code": "074101523",
            "telephone_number": "201-791-8088",
            "fax_number": "201-791-2202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1919 MADISON AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100352745",
            "telephone_number": "212-987-1777",
            "fax_number": "212-987-1776"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HENRY G. GODFREY, M.D., P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-09",
        "last_updated": "2015-12-24",
        "status": "A",
        "authorized_official_last_name": "GODFREY",
        "authorized_official_first_name": "HENRY",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "212-987-1777",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": "NY",
            "license": "130605",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EMPIRE BLUE CROSS BLUE SH",
            "identifier": "0833H",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00622904",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 24, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.