Sumner Harold Goodman, M.D.

Individual provider Active NPI Psychiatry Physician · Loudonville, NY

NPI 1407956576 · NPPES record last updated Jan 7, 2013

Key facts

NPI
1407956576
Entity type
Individual (NPI type 1)
Primary specialty
Psychiatry Physician 2084P0800X
License
NY130898 (NY)
Practice address
11 Hills Rd
Loudonville, NY 12211-1320
Phone
(518) 782-0722
NPI assigned
Sep 25, 2006
Sex
Male
Sole proprietor
No

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
NY130898NYMDPsychiatry Physician

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X NY130898 NY Yes

Addresses

Primary practice location

11 Hills Rd
Loudonville, NY 12211-1320

Mailing address

11 Hills Rd
Loudonville, NY 12211-1320
Phone (518) 782-0722

Other providers in Loudonville, NY

All providers in Loudonville, NY · Psychiatry Physician in New York

Sources for this page

Verify at the official NPI Registry.