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General NPI Number Information
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NPI Number | 1003835182
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Entity Type | Individual
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Provider Name | HECTOR H GOA MD
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Gender | Male
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Dates
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Enumeration Date | 07/19/2006
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Last Update Date | 02/20/2024
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Provider Practice Location Address
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Address Line | 1623 3RD AVE STE 201
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City | NEW YORK
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State | NY
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Zip | 10128-3638
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Country | US
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Telephone | 212-289-4839
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Fax | 845-365-3604
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Provider Business Mailing Address
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Address Line | 160 HIGH AVE
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City | NYACK
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State | NY
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Zip | 10960-2503
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Country | US
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Telephone | 212-289-4839
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Fax | 845-365-3604
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0804X
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Taxonomy Name | Child & Adolescent Psychiatry Physician
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License Number | 135882-1
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 135882
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License Number State | NY
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