Healthcare Provider Details

I. General information

NPI: 1043759525
Provider Name (Legal Business Name): BK GOYAL MD PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/17/2017
Last Update Date: 02/17/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

333 BROADWAY
AMITYVILLE NY
11701
US

IV. Provider business mailing address

129 MELANIE DR.
EAST MEADOW NY
11554
US

V. Phone/Fax

Practice location:
  • Phone: 631-789-2020
  • Fax: 631-789-5669
Mailing address:
  • Phone: 631-789-2020
  • Fax: 631-789-5669

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. BRIJESH GOYAL
Title or Position: MD
Credential:
Phone: 631-789-5669