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NPI Code Detail

MEDICARE: MISTY GOYAL OTR/L

MEDICARE:   MISTY  GOYAL  OTR/L
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
1225X00000XOccupational TherapistOC017276PA

General Provider Information

NPI Number : 1558867879
Entity Type Code : Individual
Provider Name (Legal Business Name) : MISTY GOYAL OTR/L
Provider Business Mailing Address
First Line : 115 EVERGREEN ST UNIT 103
Second Line :
City : WEST BABYLON
State : NY
Zip : 11704-7738
Country : US
Telephone Number : 412-735-3782
Fax Number :
Provider Business Practice Location Address
First Line : 115 EVERGREEN ST UNIT 103
Second Line :
City : WEST BABYLON
State : NY
Zip : 11704-7738
Country : US
Telephone Number : 412-735-3782
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/04/2018
Last Update Date : 03/29/2022

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Directions to “ MISTY GOYAL OTR/L” Practice Location

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