Provider Demographics
NPI:1538102413
Name:GOYAL, MADHU (MD)
Entity Type:Individual
Prefix:DR
First Name:MADHU
Middle Name:
Last Name:GOYAL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2509 PARK AVE
Mailing Address - Street 2:STE1A
Mailing Address - City:SOUTH PLAINFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07080-5300
Mailing Address - Country:US
Mailing Address - Phone:908-668-8290
Mailing Address - Fax:908-561-4914
Practice Address - Street 1:2509 PARK AVE
Practice Address - Street 2:SUITE#1A
Practice Address - City:SOUTH PLAINFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07080-5300
Practice Address - Country:US
Practice Address - Phone:908-668-8290
Practice Address - Fax:908-561-4914
Is Sole Proprietor?:No
Enumeration Date:2006-06-14
Last Update Date:2022-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA055524002080N0001X
NJMA055524208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No2080N0001XAllopathic & Osteopathic PhysiciansPediatricsNeonatal-Perinatal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ222842501OtherBCBS