Individual
DR. AJAY GOEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
91 PERIMETER RD STE 120, ROME, NY 13441-4018
(315) 337-0539
(315) 337-0645
Mailing address
91 PERIMETER RD STE 120, ROME, NY 13441-4018
(315) 337-0539
(315) 337-0645
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
1630511
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000008462
EXCELLUS
—
01
—
01127522
MEDICAID
—
01
—
040426013748
FIDELIS
—
01
—
100016994
RR MEDICARE
—
01
—
10060788
CDPHP
—
01
—
105078
MVP
—
01
—
9610144
GHI
—
Enumeration date
10/24/2005
Last updated
01/26/2021
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