Healthcare Provider Details

I. General information

NPI: 1477936078
Provider Name (Legal Business Name): RITU GOEL, MD, ENT, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/01/2015
Last Update Date: 07/01/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

118 DUDLEY ST
PROVIDENCE RI
02865
US

IV. Provider business mailing address

118 DUDLEY ST
PROVIDENCE RI
02865
US

V. Phone/Fax

Practice location:
  • Phone: 401-273-4155
  • Fax:
Mailing address:
  • Phone: 401-273-4155
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number
License Number State

VIII. Authorized Official

Name: MRS. RITU GOEL
Title or Position: OWNER
Credential: MD
Phone: 401-273-4155