Provider Demographics
NPI:1801959085
Name:GONCHAR, JOEL (MD)
Entity type:Individual
Prefix:DR
First Name:JOEL
Middle Name:
Last Name:GONCHAR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 WATERS EDGE
Mailing Address - Street 2:
Mailing Address - City:RYE
Mailing Address - State:NY
Mailing Address - Zip Code:10580-3254
Mailing Address - Country:US
Mailing Address - Phone:212-879-8892
Mailing Address - Fax:914-472-6409
Practice Address - Street 1:14 WATERS EDGE
Practice Address - Street 2:
Practice Address - City:RYE
Practice Address - State:NY
Practice Address - Zip Code:10580-3254
Practice Address - Country:US
Practice Address - Phone:212-879-8892
Practice Address - Fax:914-472-6409
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-18
Last Update Date:2025-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1065382084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY956691Medicare ID - Type Unspecified
B20397Medicare UPIN