Provider Demographics
NPI:1528642253
Name:GOODFELLOW, BRITTANY MEGAN (RN)
Entity type:Individual
Prefix:
First Name:BRITTANY
Middle Name:MEGAN
Last Name:GOODFELLOW
Suffix:
Gender:F
Credentials:RN
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Mailing Address - Street 1:3871 HARLEM RD STE 202
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14215-1946
Mailing Address - Country:US
Mailing Address - Phone:716-836-7510
Mailing Address - Fax:
Practice Address - Street 1:2157 MAIN ST
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14214-2648
Practice Address - Country:US
Practice Address - Phone:716-836-7510
Practice Address - Fax:716-832-3540
Is Sole Proprietor?:No
Enumeration Date:2021-05-10
Last Update Date:2021-05-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY687527367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered