1609229228 NPI number — REEMA GOEL

Table of content: REEMA GOEL (NPI 1609229228)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1609229228 NPI number — REEMA GOEL

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
GOEL
Provider First Name:
REEMA
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:
F

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:
1609229228
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/03/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
9910 FRANKLIN SQUARE DR # 2110
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BALTIMORE
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
21236-4902
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
410-933-6421
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
601 N CAROLINE ST # R00M4210
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BALTIMORE
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
21287-0006
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
410-955-5000
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/19/2016

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: 2085N0904X , with the licence number:  D88139 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: D88139 . This is a "LICENSE" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".