Provider Demographics
NPI:1558325043
Name:GOYER, RICHARD P JR (MD)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:P
Last Name:GOYER
Suffix:JR
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 1:1365 WASHINGTON AVE
Mailing Address - Street 2:SUITE 201
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12206-1068
Mailing Address - Country:US
Mailing Address - Phone:518-489-4446
Mailing Address - Fax:518-489-4448
Practice Address - Street 1:1365 WASHINGTON AVE
Practice Address - Street 2:SUITE 201
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12206-1068
Practice Address - Country:US
Practice Address - Phone:518-489-4446
Practice Address - Fax:518-489-4448
Is Sole Proprietor?:No
Enumeration Date:2006-04-13
Last Update Date:2023-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY208715207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY15616OtherMVP PROVIDER#
NY160044347OtherRAILROAD MEDICARE
NY01789615Medicaid
NY10023171OtherCDPHP PROVIDER #
NY15616OtherMVP PROVIDER#
NY160044347OtherRAILROAD MEDICARE