Provider Demographics
NPI:1003902750
Name:GORAN, ARNOLD (MD)
Entity Type:Individual
Prefix:DR
First Name:ARNOLD
Middle Name:
Last Name:GORAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 227
Mailing Address - Street 2:
Mailing Address - City:STAATSBURG
Mailing Address - State:NY
Mailing Address - Zip Code:12580-0227
Mailing Address - Country:US
Mailing Address - Phone:845-889-8200
Mailing Address - Fax:845-889-8485
Practice Address - Street 1:1 WEBSTER AVE
Practice Address - Street 2:SUITE 300
Practice Address - City:POUGHKEEPSIE
Practice Address - State:NY
Practice Address - Zip Code:12601-1361
Practice Address - Country:US
Practice Address - Phone:845-889-8200
Practice Address - Fax:845-889-8485
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-04
Last Update Date:2010-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY090962-1174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00144629Medicaid
NY26778CW961Medicare ID - Type Unspecified
NY00144629Medicaid