Provider Demographics
NPI:1104843945
Name:GULATI & GOYAL PHYSICIANS, LLP
Entity Type:Organization
Organization Name:GULATI & GOYAL PHYSICIANS, LLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:M.D.
Authorized Official - Prefix:DR
Authorized Official - First Name:VINOD
Authorized Official - Middle Name:
Authorized Official - Last Name:GULATI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:631-789-2020
Mailing Address - Street 1:333 BROADWAY
Mailing Address - Street 2:
Mailing Address - City:AMITYVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:11701-2719
Mailing Address - Country:US
Mailing Address - Phone:631-789-2020
Mailing Address - Fax:631-789-5669
Practice Address - Street 1:333 BROADWAY
Practice Address - Street 2:
Practice Address - City:AMITYVILLE
Practice Address - State:NY
Practice Address - Zip Code:11701-2719
Practice Address - Country:US
Practice Address - Phone:631-789-2020
Practice Address - Fax:631-789-5669
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-17
Last Update Date:2015-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY153SA1Medicare ID - Type UnspecifiedMEDICARE NUMBER
NY1648G1Medicare ID - Type UnspecifiedMEDICARE NUMBER
NY081SH1Medicare ID - Type UnspecifiedMEDICARE NUMBER
NY29I363Medicare ID - Type UnspecifiedMEDICARE NUMBER
NY4287F1Medicare ID - Type UnspecifiedMEDICARE NUMBER
NY43A481Medicare ID - Type UnspecifiedMEDICARE NUMBER
NY203AR1Medicare ID - Type UnspecifiedMEDICARE NUMBER
NY0280G1Medicare ID - Type UnspecifiedMEDICARE NUMBER