BRYAN DAVID GODDUHN (NPI# 1902380363) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1902380363 |
| Entity Type | Individual |
| Full Name | BRYAN DAVID GODDUHN |
| Credential | APRN |
| Practice Address |
536 Saybrook Rd Middletown CT 06457-4783 |
| Practice Telephone | 8603582220 |
| Practice Fax Number | 8603582220 |
| Mailing Telephone | 8603582218 |
| Mailing Fax Number | 8603582222 |
| Enumeration Date | 2018-09-21 |
| Last Update Date | 2019-07-24 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LA2100X |
Nurse Practitioner Specialization: Acute Care |
RN2311935 | MA | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363LG0600X |
Nurse Practitioner Specialization: Gerontology |
RN2311935 | MA | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 250 Flat Rock Pl, Westbrook, CT 064983585 | 8606619000 |
| Street Address |
536 SAYBROOK RD |
| City | MIDDLETOWN |
| State | CT |
| Zip Code | 06457-4783 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366431967 | Anwar M Khan | Radiology | 536 Saybrook Rd, Middletown, CT 06457-4783 | 2005-10-17 |
| 1831442276 | Megan E Homes | Nurse Practitioner | 536 Saybrook Rd, Middletown, CT 06457-4783 | 2012-10-23 |
| 1891084380 | Steven Oh | Radiology | 536 Saybrook Rd, Middlesex Hospital Cancer Center, Middletown, CT 06457 | 2011-04-05 |
| 1730316068 | Karthikeyan Kandavelou | Internal Medicine | 536 Saybrook Rd, Middletown, CT 06457-4783 | 2009-06-12 |
| 1467659557 | Elizabeth Ann Mariano | Internal Medicine | 536 Saybrook Rd, Middletown, CT 06457 | 2007-07-02 |
| 1881817492 | Sharon L. Hines | Nurse Practitioner | 536 Saybrook Rd, Middletown, CT 06457-4712 | 2007-04-11 |
| 1902962905 | Central Connecticut Radiation Oncology PC | Internal Medicine | 536 Saybrook Rd, Middlesex Hospital Cancer Center, Middletown, CT 06457 | 2006-12-28 |
| 1467559856 | Robert J. Levy | Internal Medicine | 536 Saybrook Rd, Middletown, CT 06457-4712 | 2006-09-20 |
| 1174629349 | James E Brown | Internal Medicine | 536 Saybrook Rd, Middletown, CT 06457-4712 | 2006-09-15 |
| 1033215132 | Miklos C. Fogarasi | Internal Medicine | 536 Saybrook Rd, Middletown, CT 06457-4712 | 2006-09-15 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699391961 | Meghan Harrington | Behavior Technician | 101 Centerpoint Drive #243, Middletown, CT 06457 | 2020-06-22 |
| 1427619626 | Collaborative Aba Services, LLC | Behavioral Analyst | 515 Centerpoint Drive, Suite 205, Middletown, CT 06457 | 2019-06-27 |
| 1376100339 | Kimberly Tynik | Pharmacist | 451 Fowler Ave, Middletown, CT 06457 | 2019-05-24 |
| 1184101263 | Tabrez Adil | Dentist | 675 Main St., Middletown, CT 06457 | 2018-07-23 |
| 1326535337 | Rehan Khan | Non-emergency Medical Transport (VAN) | 765 Country Club Rd, Middletown, CT 06457 | 2018-04-16 |
| 1366950206 | State of Connecticut | Psychiatric Hospital | 70 O'brien Drive, Middletown, CT 06457 | 2018-01-12 |
| 1902324536 | Cynthia Tine | Physical Therapy Assistant | 628 Congdon Street, Middletown, CT 06457 | 2017-09-04 |
| 1619494390 | Nathan Douglas Roy | Specialist/Technologist | 431 Briarwood Lane, Middletown, CT 06457 | 2017-08-24 |
| 1598286502 | Rachel Hoffman Whelen | Registered Nurse | 420 Saybrook Road, Suite A, Middletown, CT 06457 | 2017-06-29 |
| 1003358326 | Rebecca Rotondo | Social Worker | 230 Main Street Extension, Act Team, Gilead Community Services, Middletown, CT 06457 | 2016-11-17 |
| Find all providers in zip 06457 | ||||
| Taxonomy Code | 363LA2100X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Acute Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801375605 | Cecelia Glynn Echevarria | Nurse Practitioner | 25 John Kesson Ln, Middletown, RI 02842-4654 | 2018-08-13 |
| 1881998060 | Debra Lynn Mcgrath | Nurse Practitioner | 6 Brookline Ct, Middletown, NJ 07748-3302 | 2011-01-03 |
| 1164405619 | Rebecca Lynn Edwards | Nurse Practitioner | 28 Crescent Street, Middlesex Hospital Hospice and Palliative Care, Middletown, CT 06457 | 2005-11-29 |
| 1396358552 | Rachel Chassen | Nurse Practitioner | 707 E Main St, Middletown, NY 10940-2650 | 2020-08-27 |
| 1912492075 | Paul Gyorgyfi | Nurse Practitioner | 1 Medical Center Dr, Middletown, OH 45005 | 2018-06-29 |
| 1760905756 | Jennifer Nicole Selby | Nurse Practitioner | 707 E Main St, Middletown, NY 10940-2650 | 2017-07-20 |
| 1679093801 | Anthony Rella | Nurse Practitioner | 707 E Main St, Middletown, NY 10940-2650 | 2017-06-20 |
| 1972033058 | Callie Marie Schlosser | Nurse Practitioner | 707 E Main St, Middletown, NY 10940-2650 | 2017-06-12 |
| 1669821716 | Kelsey Kies | Nurse Practitioner | 1 Medical Center Dr Fl 3, Middletown, OH 45005 | 2016-06-09 |
| 1306206834 | Stacy Thomas | Nurse Practitioner | 1 Medical Center Dr, Middletown, OH 45005-2584 | 2016-02-25 |
| Find all providers in MIDDLETOWN | ||||
| City | MIDDLETOWN |
| Zip Code | 06457 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.