Provider Demographics
NPI:1154399624
Name:GOODFRIEND, ANDREW N (MD)
Entity type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:N
Last Name:GOODFRIEND
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:919 WESTFALL RD STE A205
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14618-2680
Mailing Address - Country:US
Mailing Address - Phone:585-244-2580
Mailing Address - Fax:585-244-3741
Practice Address - Street 1:919 WESTFALL RD STE A205
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14618-2680
Practice Address - Country:US
Practice Address - Phone:585-244-2580
Practice Address - Fax:585-244-3741
Is Sole Proprietor?:No
Enumeration Date:2006-03-10
Last Update Date:2011-05-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY192691207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01629414Medicaid
NYG22922Medicare UPIN
NY01629414Medicaid