Individual provider Active NPI

Suzanne Goodwin

  • Psychoanalyst
  • Ridgewood, NJ
National Provider Identifier
1083271001
Registry record updated May 24, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychoanalystTaxonomy code 102L00000X
License
000994-1 Issued in NY
Practice address
88 W Ridgewood Ave
Ridgewood, NJ 07450-3199
Phone
(914) 589-6629
Fax
(914) 589-6629
NPI assigned
May 24, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 24, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychoanalyst 102L00000X 000994-1 NY Primary

Addresses

Primary practice location

88 W Ridgewood Ave
Ridgewood, NJ 07450-3199

Mailing address

88 W Ridgewood Ave
Ridgewood, NJ 07450-3199
Phone (914) 589-6629

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
000994-1NYMDPsychoanalyst

NPI Registry JSON

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

{
    "created_epoch": "1558656000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1558656000000",
    "number": "1083271001",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "88 W RIDGEWOOD AVE",
            "city": "RIDGEWOOD",
            "state": "NJ",
            "postal_code": "074503199",
            "telephone_number": "914-589-6629",
            "fax_number": "914-589-6629"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "88 W RIDGEWOOD AVE",
            "city": "RIDGEWOOD",
            "state": "NJ",
            "postal_code": "074503199",
            "telephone_number": "914-589-6629",
            "fax_number": "914-589-6629"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOODWIN",
        "first_name": "SUZANNE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-05-24",
        "last_updated": "2019-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "102L00000X",
            "taxonomy_group": "",
            "desc": "Psychoanalyst",
            "state": "NY",
            "license": "000994-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ridgewood, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2019; 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.