Bonnie Goodchild

Individual provider Active NPI Licensed Practical Nurse · Dover Plains, NY

NPI 1922517002 · NPPES record last updated Sep 21, 2017

Key facts

NPI
1922517002
Entity type
Individual (NPI type 1)
Primary specialty
Licensed Practical Nurse 164W00000X
License
322339 (NY)
Practice address
15 Wayne Dr
Dover Plains, NY 12522-6023
Phone
(845) 372-7366
NPI assigned
Sep 21, 2017
Sex
Female
Sole proprietor
Yes

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
322339NYMDLicensed Practical Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 322339 NY Yes

Addresses

Primary practice location

15 Wayne Dr
Dover Plains, NY 12522-6023

Mailing address

15 Wayne Drive
Dover Plains, NY 12522

Other providers in Dover Plains, NY

All providers in Dover Plains, NY · Licensed Practical Nurse in New York

Sources for this page

Verify at the official NPI Registry.