Individual
DR. WILLIAM M. GOUMAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
257 LAFAYETTE AVE, SUITE 200, SUFFERN, NY 10901-4830
(845) 369-8800
(845) 357-0086
Mailing address
20 GRAND ST FL 3, CREDENTIALING MANAGER, WARWICK, NY 10990-1035
(845) 987-3906
(845) 987-5979
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
170446
NY
2086X0206X
Surgical Oncology Physician
170446
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0257010
—
NJ
05
—
02812531
—
NY
01
—
P01006368
MEDCIARE RR
NY
Enumeration date
06/10/2005
Last updated
07/29/2015
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