Kelly Lynn Goodman, PHARMD

Primary specialty

PharmacistTaxonomy code 183500000X

License

064566 Issued in NY

Practice address

102 N Main St
Sayville, NY 11782-2508

Phone

(631) 218-7982

NPI assigned

Aug 31, 2018

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Walgreen Co

  • Pharmacy
  • Sayville, NY
  • NPI 1306033204
  NPD (past)
• Walgreen Co

  • Pharmacy
  • Longview, TX
  • NPI 1629956545
  NPD (past)

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

{
    "created_epoch": "1535673600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1535673600000",
    "number": "1831671387",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24 SEUSING BLVD",
            "city": "RONKONKOMA",
            "state": "NY",
            "postal_code": "117794642",
            "telephone_number": "631-327-9463"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 N MAIN ST",
            "city": "SAYVILLE",
            "state": "NY",
            "postal_code": "117822508",
            "telephone_number": "631-218-7982"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOODMAN",
        "first_name": "KELLY",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-31",
        "last_updated": "2018-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NY",
            "license": "064566",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christine Gizoni, D.C.
• Keith J Golka
• Frank Manuel Gomez Jr., D.C.
• Good Samaritan Hospital Medical Center
• Desiree Goodman, M.S.P.T., D.P.T.
• Robert J. Grasso, O.D.
• Lauren Stacey Greenwald Froitzheim, LCSW
• Megan Elizabeth Grela-Castro, RPH
• H.E.J.J.Pharmacy LTD
• Allison Halbig, D.P.T

• Pharmacist in Sayville, NY
• Providers in Sayville, NY by specialty
• Pharmacist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2018; 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.