1447253570 NPI number — DR. ARUN GOYAL MD

Table of content: DR. ARUN GOYAL MD (NPI 1447253570)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1447253570 NPI number — DR. ARUN GOYAL MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
GOYAL
Provider First Name:
ARUN
Provider Middle Name:
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1447253570
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/07/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 5801
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NEW YORK
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
10087-5801
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
914-593-7880
Provider Business Mailing Address Fax Number:
914-593-7881

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
19 BRADHURST AVE
Provider Second Line Business Practice Location Address:
STE 700
Provider Business Practice Location Address City Name:
HAWTHORNE
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10532-2140
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
914-593-7872
Provider Business Practice Location Address Fax Number:
914-593-7881
Provider Enumeration Date:
05/23/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 2086S0129X , with the licence number:  189245 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 96E973K221 . This is a "PTAN" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: A100000178 . This is a "MEDICARE GROUP PTAN" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: A400035484 . This is a "MEDICARE INDIVIDUAL PTAN" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 01692011 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 96E973K222 . This is a "PTAN" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 770002080 . This is a "RAIL ROAD MEDICARE" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 96E9733641 . This is a "PTAN" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 96E9735223 . This is a "PTAN" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".




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