Provider Demographics
NPI:1992896260
Name:GOEBEL, ROBERT JOSEPH (DC)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:JOSEPH
Last Name:GOEBEL
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:123 FULTON AVE
Mailing Address - Street 2:
Mailing Address - City:GARDEN CITY PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11040-5305
Mailing Address - Country:US
Mailing Address - Phone:516-248-3647
Mailing Address - Fax:516-248-1347
Practice Address - Street 1:123 FULTON AVE
Practice Address - Street 2:
Practice Address - City:GARDEN CITY PARK
Practice Address - State:NY
Practice Address - Zip Code:11040-5305
Practice Address - Country:US
Practice Address - Phone:516-248-3647
Practice Address - Fax:516-248-1347
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX002957-1111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY1C8413OtherPHS
NYT52418OtherBC BS
NY0576521OtherAETNA
NY0068203OtherGHI
NY324209OtherA.C.N.
NY37710POtherPRISM
NY1C4355OtherPHS
NY1C8413OtherHEALTHNET
NY49447OtherVYTRA
NY6086122OtherCIGNA
NYC02957-1OtherWORKERS COMP
NYD07745OtherOXFORD
NYMPIN-40735OtherUNITED HEALTHCARE
NY0576521OtherAETNA
NY49447OtherVYTRA