Individual
DR. SHANTHA GANESAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
451 CLARKSON AVE, BROOKLYN, NY 11203-2054
(718) 245-4409
(718) 245-5544
Mailing address
22303 KINGSBURY AVE, BAYSIDE, OAKLAND GARDENS, NY 11364-3602
(718) 776-3090
(718) 245-5544
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
214120-1
NY
207LP2900X
Pain Medicine (Anesthesiology) Physician
214120-1
NY
Other
Enumeration date
02/02/2006
Last updated
10/22/2019
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