1821253337 NPI number — MRS. SYDNE STONE GOODIER P.T.

Table of content: MRS. SYDNE STONE GOODIER P.T. (NPI 1821253337)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1821253337 NPI number — MRS. SYDNE STONE GOODIER P.T.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
GOODIER
Provider First Name:
SYDNE
Provider Middle Name:
STONE
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
P.T.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1821253337
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/13/2017
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
8322 BELLONA AVE
Provider Second Line Business Mailing Address:
SUITE # 100
Provider Business Mailing Address City Name:
TOWSON
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
21204-2065
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
410-337-8847
Provider Business Mailing Address Fax Number:
410-337-5189

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7801 YORK RD
Provider Second Line Business Practice Location Address:
SUITE # 140
Provider Business Practice Location Address City Name:
TOWSON
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
21204-7446
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
410-337-4024
Provider Business Practice Location Address Fax Number:
443-991-4582
Provider Enumeration Date:
07/23/2008

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 225100000X , with the licence number:  24293 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 24293 . This is a "MARYLAND PT LICENSE" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com