Provider Demographics
NPI:1881690451
Name:GOYAL, VIPIN K (MD)
Entity Type:Individual
Prefix:
First Name:VIPIN
Middle Name:K
Last Name:GOYAL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:333 E CITY AVE
Mailing Address - Street 2:2 BALA PLAZA
Mailing Address - City:BALA CYNWYD
Mailing Address - State:PA
Mailing Address - Zip Code:19004-1501
Mailing Address - Country:US
Mailing Address - Phone:610-668-2777
Mailing Address - Fax:610-668-1509
Practice Address - Street 1:333 E CITY AVE
Practice Address - Street 2:2 BALA PLAZA
Practice Address - City:BALA CYNWYD
Practice Address - State:PA
Practice Address - Zip Code:19004-1501
Practice Address - Country:US
Practice Address - Phone:610-668-2777
Practice Address - Fax:610-668-1509
Is Sole Proprietor?:No
Enumeration Date:2005-06-28
Last Update Date:2010-04-02
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PAMD073666L207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ2837500000OtherINDEPENDENCE BLUE CROSS
NJ1593433OtherAETNA HMO
PA2007759000OtherKEYSTONE HEALTH PLAN EAST
PA2007759000OtherPERSONAL CHOICE
PA1314044OtherBLUE SHIELD
PA30030753OtherKEYSTONE MERCY HEALTH PL
PAA2279OtherMEDICARE ID TYPE UNSPECIFIED
PA0018747550004Medicaid
PA2007759000OtherINDEPENDENCE BLUE CROSS
PA7908327OtherCIGNA
NJ0103161Medicaid
NJ1958882OtherBLUE SHIELD
PA0007220294OtherAETNA PPO
PA10240MD073666LOtherHEALTH PARTNERS
PA1256275OtherAETNA HMO
PA1984726OtherUNITED HEALTHCARE
NJ2837500000OtherAMERIHEALTH
PA2007759000OtherINDEPENDENCE BLUE CROSS
NJ110916DCQMedicare PIN
NJ1958882OtherBLUE SHIELD
PA30030753OtherKEYSTONE MERCY HEALTH PL