Individual
SUSHEER GANDOTRA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
175 E BROWN ST, SUITE 114, EAST STROUDSBURG, PA 18301-3098
(570) 426-2301
(570) 426-2306
Mailing address
206 E. BROWN ST., POCONO HEALTHCARE MGMT.-PROFESSIONAL CENTER, EAST STROUDSBURG, PA 18301
(570) 420-4951
(570) 476-3754
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
C1-0008498
DE
207RI0200X
Infectious Disease Physician
Primary
MD435097
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1021961250001
—
PA
01
—
1083663694
NPI
DE
Enumeration date
05/09/2006
Last updated
12/29/2010
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