Individual
DR. ISHITA BANSAL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
200 OLD COUNTRY RD STE 135, MINEOLA, NY 11501-4237
(516) 663-2169
Mailing address
7901 BROADWAY, C7 -10, ELMHURST, NY 11373-1329
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
284014
NY
207RN0300X
Nephrology Physician
Primary
284014
NY
Other
Enumeration date
08/13/2012
Last updated
06/06/2022
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