Healthcare Provider Details

I. General information

NPI: 1104569292
Provider Name (Legal Business Name): AREEN MAHRYA GORAYA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/15/2022
Last Update Date: 07/25/2025
Certification Date: 07/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13819 HANSON BLVD NW
ANDOVER MN
55304-7608
US

IV. Provider business mailing address

13819 HANSON BLVD NW
ANDOVER MN
55304-7608
US

V. Phone/Fax

Practice location:
  • Phone: 763-392-4001
  • Fax:
Mailing address:
  • Phone: 763-392-4001
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number79849
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: