MEDICARE: PRADEEP GOYAL M.D.,

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	2085R0202X	Diagnostic Radiology Physician	1.055285	CT
2	2085R0202X	Diagnostic Radiology Physician	MD-48035	IA
3	2085R0204X	Vascular & Interventional Radiology Physician	297535-01	NY

General Provider Information

NPI Number	:	1699054601
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PRADEEP GOYAL M.D.,

Provider Business Mailing Address
First Line	:	441 CENTRAL PARK AVE
Second Line	:	SUITE 627
City	:	SCARSDALE
State	:	NY
Zip	:	10583-3559
Country	:	US
Telephone Number	:	914-200-1586
Fax Number	:

Provider Business Practice Location Address
First Line	:	1976 CROTONA PKWY
Second Line	:	3RD FLOOR, STE 3C
City	:	BRONX
State	:	NY
Zip	:	10460-1526
Country	:	US
Telephone Number	:	914-200-1586
Fax Number	:	914-200-1586

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

Provider Enumeration Date	:	08/08/2011
Last Update Date	:	06/12/2025

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