Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Brandon Michael Goodlavage

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1417439779

Brandon Michael Goodlavage is a Student in an Organized Health Care Education/Training Program in Wilkes Barre, Pennsylvania. Licensed in Pennsylvania. Registered with an NPI since 2018.

Licensed in
PA
In the registry since
2018
Specialties on file
3

Practice location Address checks out

133 N River St
Wilkes Barre, PA 18711-0800
Phone: (570) 208-5900
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Athletic Trainer (primary) Taxonomy 2255A2300X · Licence RT007594 (PA)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X
Athletic Trainer Taxonomy 2255A2300X

Record details

NPI number1417439779
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedSeptember 4, 2018
Last updated in NPPESApril 10, 2024
Certification dateApril 10, 2024

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