Most Relevant Information
Provider Data
NPI Number: | 1003413634 |
Provider Name: | REBA GOODROW APRN |
Entity Type: | Individual |
Taxonomy Code: | 363LF0000X |
Specialty: | Nurse Practitioner |
License Number: | 9240 |
Most Important Dates
Enumeration Date: | 10/06/2020 |
Last Updated: | 01/01/2022 |
Provider Practice Location
1 POMPERAUG OFFICE PARK STE 102&103
SOUTHBURY
CT
064882295
Practice Location Phone/Fax
Phone: | 2035581143 |
Fax: |
Provider Mailing Location
82 CENTRAL AVE
WOLCOTT
CT
067163002
Provider Mailing Phone/Fax
Phone: | 2035897867 |
Fax: |