Individual
DR. JAYA GOSWAMI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
13515 TIVOLI LAKE BLVD, SILVER SPRING, MD 20906-6722
(716) 400-4788
Mailing address
13515 TIVOLI LAKE BLVD, SILVER SPRING, MD 20906-6722
(716) 400-4788
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
MD469416
PA
2080P0208X
Pediatric Infectious Diseases Physician
MD469416
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
ENROLLED
—
IL
Enumeration date
10/31/2011
Last updated
02/01/2021
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