Provider Demographics
NPI:1043363864
Name:DR FRANZ GOYZUETA
Entity Type:Organization
Organization Name:DR FRANZ GOYZUETA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:FRANZ
Authorized Official - Middle Name:E
Authorized Official - Last Name:GOYZUETA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:212-928-8888
Mailing Address - Street 1:581 W 161ST ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10032-6102
Mailing Address - Country:US
Mailing Address - Phone:212-928-8888
Mailing Address - Fax:212-928-7882
Practice Address - Street 1:581 W 161ST ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10032-6102
Practice Address - Country:US
Practice Address - Phone:212-928-8888
Practice Address - Fax:212-928-7882
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-18
Last Update Date:2011-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & OncologyGroup - Multi-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02214331Medicaid
NYWAA411OtherMEDICARE PTAN NUMBER