Provider Demographics
NPI:1104939586
Name:GOODMAN KADEN, GAIL (MD)
Entity type:Individual
Prefix:DR
First Name:GAIL
Middle Name:
Last Name:GOODMAN KADEN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 S OYSTER BAY RD
Mailing Address - Street 2:SUITE 207
Mailing Address - City:HICKSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:11801-3500
Mailing Address - Country:US
Mailing Address - Phone:516-822-1400
Mailing Address - Fax:516-822-5602
Practice Address - Street 1:400 S OYSTER BAY RD
Practice Address - Street 2:SUITE 207
Practice Address - City:HICKSVILLE
Practice Address - State:NY
Practice Address - Zip Code:11801-3500
Practice Address - Country:US
Practice Address - Phone:516-822-1400
Practice Address - Fax:516-822-5602
Is Sole Proprietor?:No
Enumeration Date:2006-08-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY167890208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYE87283Medicare UPIN