Provider Demographics
NPI:1124269535
Name:GOODMAN, CAROLE L (OTR/L)
Entity type:Individual
Prefix:
First Name:CAROLE
Middle Name:L
Last Name:GOODMAN
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:CAROLE
Other - Middle Name:L
Other - Last Name:WEIL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR
Mailing Address - Street 1:6 NEWTON STREET
Mailing Address - Street 2:
Mailing Address - City:DUNKIRK
Mailing Address - State:NY
Mailing Address - Zip Code:14048-2720
Mailing Address - Country:US
Mailing Address - Phone:716-673-6709
Mailing Address - Fax:
Practice Address - Street 1:423 MAIN STREET
Practice Address - Street 2:OCCUPATIONAL THERAPY AND HAND REHABILITATION
Practice Address - City:DUNKIRK
Practice Address - State:NY
Practice Address - Zip Code:14048-2720
Practice Address - Country:US
Practice Address - Phone:716-366-3417
Practice Address - Fax:716-366-3568
Is Sole Proprietor?:No
Enumeration Date:2009-03-13
Last Update Date:2009-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY001654-1225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist