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NPI Code Detail

MEDICARE: DR. VIRAL GORADIA M.B.B.S

MEDICARE: DR. VIRAL GORADIA M.B.B.S
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
1390200000XStudent in an Organized Health Care Education/Training Program
22084P0800XPsychiatry Physician276813NY

General Provider Information

NPI Number : 1871880989
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. VIRAL GORADIA M.B.B.S
Provider Business Mailing Address
First Line : 50 PRESIDENTIAL PLZ
Second Line : APT 704
City : SYRACUSE
State : NY
Zip : 13202-2229
Country : US
Telephone Number : 315-403-4271
Fax Number :
Provider Business Practice Location Address
First Line : 713 HARRISON ST
Second Line :
City : SYRACUSE
State : NY
Zip : 13210-2305
Country : US
Telephone Number : 315-247-2447
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/09/2011
Last Update Date : 03/10/2015

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