Provider Demographics
NPI:1386789766
Name:GOODMAN, STUART H
Entity type:Individual
Prefix:
First Name:STUART
Middle Name:H
Last Name:GOODMAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:295 PRINCETON HIGHTSTOWN RD
Mailing Address - Street 2:UNIT 351
Mailing Address - City:WEST WINDSOR
Mailing Address - State:NJ
Mailing Address - Zip Code:08550-3123
Mailing Address - Country:US
Mailing Address - Phone:609-426-9444
Mailing Address - Fax:609-426-1806
Practice Address - Street 1:300B PRINCETON HIGHTSTOWN RD
Practice Address - Street 2:SUITE 104
Practice Address - City:EAST WINDSOR
Practice Address - State:NJ
Practice Address - Zip Code:08520-1400
Practice Address - Country:US
Practice Address - Phone:609-426-9444
Practice Address - Fax:609-426-1806
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-21
Last Update Date:2009-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ2948111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor