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

Philllip Goodman

Individual provider Optician · NPI 1760072896

Philllip Goodman is an Optician in Waterloo, New York. Practices as a sole proprietor. Licensed in New York.

Licensed in
NY
In the registry since
2021

Practice location Address checks out

204 Main Street Shop Ctr
Waterloo, NY 13165-1454
Phone: (315) 539-1209
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Optician (primary) Taxonomy 156FX1800X · Licence 010346 (NY)

Record details

NPI number1760072896
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedJanuary 22, 2021
Last updated in NPPESJanuary 22, 2021
Certification dateJanuary 22, 2021
Mailing address204 Main Street Shop Centre, Waterloo, NY 13165

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