Individual
DR. JYOTI PRAKASH GANGULY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
496 SMITHTOWN BYP, SUITE 101, SMITHTOWN, NY 11787-5005
(631) 979-8880
(631) 979-8064
Mailing address
496 SMITHTOWN BYP, SUITE 101, SMITHTOWN, NY 11787-5005
(631) 979-8880
(631) 979-8064
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
141062
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00709119
—
NY
Enumeration date
07/28/2006
Last updated
12/05/2008
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