MEDICARE: DR. ARUN GOYAL MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2086S0129X	Vascular Surgery Physician	189245	NY

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	A100000178	OTHER	NY	MEDICARE GROUP PTAN
3	A400035484	OTHER	NY	MEDICARE INDIVIDUAL PTAN
6	770002080	OTHER	NY	RAIL ROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	96E973K221	OTHER	NY	PTAN
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	96E973K222	OTHER	NY	PTAN
7	96E9733641	OTHER	NY	PTAN
8	96E9735223	OTHER	NY	PTAN

General Provider Information

NPI Number	:	1447253570
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ARUN GOYAL MD

Provider Business Mailing Address
First Line	:	PO BOX 5801
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10087-5801
Country	:	US
Telephone Number	:	914-593-7880
Fax Number	:	914-593-7881

Provider Business Practice Location Address
First Line	:	19 BRADHURST AVE
Second Line	:	STE 700
City	:	HAWTHORNE
State	:	NY
Zip	:	10532-2140
Country	:	US
Telephone Number	:	914-593-7872
Fax Number	:	914-593-7881

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/23/2005
Last Update Date	:	12/07/2021

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Directions to “ DR. ARUN GOYAL MD” Practice Location

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