Provider Demographics
NPI:1417903477
Name:GOYAL, JANAK RAJ (MD)
Entity Type:Individual
Prefix:
First Name:JANAK
Middle Name:RAJ
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 1:8 DISBROW RD
Mailing Address - Street 2:
Mailing Address - City:MATAWAN
Mailing Address - State:NJ
Mailing Address - Zip Code:07747-6810
Mailing Address - Country:US
Mailing Address - Phone:732-566-3405
Mailing Address - Fax:
Practice Address - Street 1:528 AMBOY AVE
Practice Address - Street 2:
Practice Address - City:PERTH AMBOY
Practice Address - State:NJ
Practice Address - Zip Code:08861-3118
Practice Address - Country:US
Practice Address - Phone:732-442-1006
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-25
Last Update Date:2010-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA05588800207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ6349200Medicaid
NJ051864Medicare ID - Type Unspecified
NJ6349200Medicaid