Marilyn D Goodman, REGISTERED NURSE

Primary specialty

School Registered NurseTaxonomy code 163WS0200X

License

284222-1 Issued in NY

Practice address

848 Pierson Ave.
Newark, NY 14513

Phone

(315) 331-2086

NPI assigned

Dec 3, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1228262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1228262400000",
    "number": "1124263322",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "762 TOWNLINE RD",
            "city": "LYONS",
            "state": "NY",
            "postal_code": "144899619",
            "telephone_number": "315-331-2086"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "848 PIERSON AVE.",
            "city": "NEWARK",
            "state": "NY",
            "postal_code": "14513",
            "telephone_number": "315-331-2086"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOODMAN",
        "first_name": "MARILYN",
        "middle_name": "D",
        "credential": "REGISTERED NURSE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-12-03",
        "last_updated": "2008-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WS0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, School",
            "state": "NY",
            "license": "284222-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ROOSEVELT CHILDREN'S CENTER",
            "identifier": "23-7540582",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ROOSEVELT CHILDREN'S CENTER",
            "identifier": "1043414170",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Janice Lynn Gibala-Broxholm, CCC/LIC
• Alyssa Gibbs, DPT
• Jessica Giles, RN
• Donna Michelle Golden, PT
• Nicole Goldfarb, RN
• Anne Coleman Gould, PT
• Chrystal Renee Greene, LPN
• Elizabeth Hannah Grefrath, LMSW
• Theresa Gregg, RNFA
• Leah Grey

• School Registered Nurse in Newark, NY
• Providers in Newark, NY by specialty
• School Registered Nurse in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2008; 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.