Healthcare Provider Details

I. General information

NPI: 1902369093
Provider Name (Legal Business Name): GOYAL PSYCHIATRY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/08/2019
Last Update Date: 10/15/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1240 E 9TH ST
RENO NV
89512-2964
US

IV. Provider business mailing address

10230 ROLLINS DR
RENO NV
89521-3173
US

V. Phone/Fax

Practice location:
  • Phone: 347-654-7109
  • Fax:
Mailing address:
  • Phone: 347-654-7109
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: DHARMENDRA GOYAL
Title or Position: OWNER
Credential: MD
Phone: 347-654-7109