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Organization
PHYSICAL MEDICINE AND REHABILITATION OF NY
Active
Organization
PHYSICAL MEDICINE AND REHABILITATION OF NY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GAUTAM KAUSHIK KHAKHAR M.D. (MEDICAL DIRECTOR)
(718) 549-7260
Entity
Organization
Contact information
Practice address
3815 PUTNAM AVE W, BRONX, NY 10463-2442
(718) 549-7260
Mailing address
9520 QUEENS BLVD, REGO PARK, NY 11374-1136
(718) 459-1280
Taxonomy
Speciality
Code
Description
License number
State
2081S0010X
Sports Medicine (Physical Medicine & Rehabilitation) Physician
Primary
218201
NY
Other
Enumeration date
03/14/2007
Last updated
08/22/2020
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