Provider Demographics
NPI:1003835182
Name:GOA, HECTOR H (MD)
Entity Type:Individual
Prefix:DR
First Name:HECTOR
Middle Name:H
Last Name:GOA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:HECTOR
Other - Middle Name:H
Other - Last Name:GOA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:160 HIGH AVE
Mailing Address - Street 2:
Mailing Address - City:NYACK
Mailing Address - State:NY
Mailing Address - Zip Code:10960-2503
Mailing Address - Country:US
Mailing Address - Phone:212-289-4839
Mailing Address - Fax:845-365-3604
Practice Address - Street 1:1623 3RD AVE STE 201
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10128-3638
Practice Address - Country:US
Practice Address - Phone:212-289-4839
Practice Address - Fax:845-365-3604
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-19
Last Update Date:2024-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY135882-12084P0804X
NY1358822084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00706881Medicaid
NY39D161OtherMEDICARE
NY39D161OtherMEDICARE