Healthcare Provider Details

I. General information

NPI: 1255993408
Provider Name (Legal Business Name): ROOPALI GOYAL GANDHI MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/08/2019
Last Update Date: 03/10/2025
Certification Date: 03/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2460 CURTIS ELLIS DR
ROCKY MOUNT NC
27804-2237
US

IV. Provider business mailing address

1425 PORTLAND AVE
ROCHESTER NY
14621-3011
US

V. Phone/Fax

Practice location:
  • Phone: 828-456-7311
  • Fax: 252-962-3320
Mailing address:
  • Phone: 585-922-4000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number318030
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number318030
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: