Provider Demographics
NPI:1164089579
Name:GOAL FAMILY MEDICAL PC
Entity Type:Organization
Organization Name:GOAL FAMILY MEDICAL PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:OGADINMA
Authorized Official - Middle Name:
Authorized Official - Last Name:MCGEACHY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:516-758-7339
Mailing Address - Street 1:5 SUNRISE PLZ STE 103
Mailing Address - Street 2:
Mailing Address - City:VALLEY STREAM
Mailing Address - State:NY
Mailing Address - Zip Code:11580-6130
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5 SUNRISE PLZ STE 103
Practice Address - Street 2:
Practice Address - City:VALLEY STREAM
Practice Address - State:NY
Practice Address - Zip Code:11580-6130
Practice Address - Country:US
Practice Address - Phone:516-758-7339
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-21
Last Update Date:2019-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty