NPI 1043218159

Glen K Goodman, MD

Practitioner Ophthalmology Physician Waterbury, CT

Practice location

Address: 87 Grandview Ave, Waterbury, CT 06708-2514
Phone: (203) 574-2020

Registered specialties (2)

Ophthalmology Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 207W00000X Licence 67111 (CT)

Other Ophthalmology providers in Connecticut →

Ophthalmology Physician

Allopathic & Osteopathic Physicians Taxonomy 207W00000X Licence 46944 (MA)

Registry record

NPI: 1043218159
Entity type: Individual
Sex (as registered): Male
NPI issued: 12 Jul 2005
Record last updated: 3 Nov 2021

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.