Provider Demographics
NPI:1578744280
Name:ARNOLD GORAN, MD PLLC
Entity Type:Organization
Organization Name:ARNOLD GORAN, MD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:ARNOLD
Authorized Official - Middle Name:
Authorized Official - Last Name:GORAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:845-889-8200
Mailing Address - Street 1:PO BOX 227
Mailing Address - Street 2:
Mailing Address - City:STAATSBURG
Mailing Address - State:NY
Mailing Address - Zip Code:12580-0227
Mailing Address - Country:US
Mailing Address - Phone:845-889-8200
Mailing Address - Fax:845-889-8485
Practice Address - Street 1:1 WEBSTER AVE
Practice Address - Street 2:SUITE 300
Practice Address - City:POUGHKEEPSIE
Practice Address - State:NY
Practice Address - Zip Code:12601-1361
Practice Address - Country:US
Practice Address - Phone:845-889-8200
Practice Address - Fax:845-889-8485
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-21
Last Update Date:2010-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY090962174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00144629Medicaid
NY00144629Medicaid