Provider Demographics
NPI:1699054601
Name:GOYAL, PRADEEP (MD,)
Entity type:Individual
Prefix:
First Name:PRADEEP
Middle Name:
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 1:441 CENTRAL PARK AVE
Mailing Address - Street 2:SUITE 627
Mailing Address - City:SCARSDALE
Mailing Address - State:NY
Mailing Address - Zip Code:10583-3559
Mailing Address - Country:US
Mailing Address - Phone:914-200-1586
Mailing Address - Fax:
Practice Address - Street 1:2365 BOSTON POST RD STE 200
Practice Address - Street 2:
Practice Address - City:LARCHMONT
Practice Address - State:NY
Practice Address - Zip Code:10538-3559
Practice Address - Country:US
Practice Address - Phone:914-200-1586
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-08-08
Last Update Date:2023-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT1.0552852085R0202X
NY297535-012085R0204X
IAMD-480352085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional Radiology
No2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology