Individual
NISHA BANSAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
256 MASON AVE, STATEN ISLAND, NY 10305-3408
(718) 226-6400
(718) 226-6404
Mailing address
256 MASON AVE, STATEN ISLAND, NY 10305-3408
(718) 226-6400
(718) 226-6404
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
238888
NY
207VX0201X
Gynecologic Oncology Physician
Primary
238888
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02938310
—
NY
Enumeration date
12/19/2007
Last updated
02/08/2013
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