Provider Demographics
NPI:1043231921
Name:GOYAL, AMEET KUMAR (MD)
Entity Type:Individual
Prefix:
First Name:AMEET
Middle Name:KUMAR
Last Name:GOYAL
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 1:167 PURCHASE ST
Mailing Address - Street 2:
Mailing Address - City:RYE
Mailing Address - State:NY
Mailing Address - Zip Code:10580-2137
Mailing Address - Country:US
Mailing Address - Phone:914-552-8955
Mailing Address - Fax:914-921-6498
Practice Address - Street 1:167 PURCHASE ST
Practice Address - Street 2:
Practice Address - City:RYE
Practice Address - State:NY
Practice Address - Zip Code:10580-2137
Practice Address - Country:US
Practice Address - Phone:914-552-8955
Practice Address - Fax:914-921-6498
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-23
Last Update Date:2020-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT035737174400000X, 207W00000X
NY199483207W00000X, 174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
No207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY317547OtherMVP
NYWS1427OtherOXFORD
NY1384626OtherUNITED HEALTHCARE
NY6012897OtherGHI
NY010035737CT01OtherANTHEM BCBS OF CT
NY40426012616OtherFIDELIS
NYEMPIRE BCBSOther70T541
NY129099OtherWELLCARE
CT180000913OtherCT MEDICARE P-TAN
NY39414119-007OtherCIGNA
NY5970211OtherAETNA
NY129099OtherWELLCARE
NYWS1427OtherOXFORD
NYF48200Medicare UPIN