Provider Demographics
NPI:1720250335
Name:HECTOR H. GOA, MD, PC
Entity type:Organization
Organization Name:HECTOR H. GOA, MD, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:HECTOR
Authorized Official - Middle Name:H
Authorized Official - Last Name:GOA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:212-289-4839
Mailing Address - Street 1:48 SOUTH BROADWAY, #826
Mailing Address - Street 2:
Mailing Address - City:NYACK
Mailing Address - State:NY
Mailing Address - Zip Code:10960
Mailing Address - Country:US
Mailing Address - Phone:212-289-4839
Mailing Address - Fax:845-365-3604
Practice Address - Street 1:1623-41 THIRD AVENUE
Practice Address - Street 2:SUITE 201M, OFFICE #2
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10028
Practice Address - Country:US
Practice Address - Phone:212-289-4839
Practice Address - Fax:845-365-3604
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-24
Last Update Date:2024-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty
No2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent PsychiatryGroup - Multi-Specialty