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Individual

ABHINAV REDDY GANGASANI

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
111 E 210TH ST, BRONX, NY 10467-2401
(718) 920-4383
(718) 653-2367
Mailing address
12 ELDORADO WAY, MONROE, NJ 08831-4510
(732) 207-5442

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
25MA12650700
NJ
390200000X
Student in an Organized Health Care Education/Training Program

Other

Enumeration date
05/03/2021
Last updated
05/01/2025
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