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Individual

BIMALENDU GANGULY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
140 BENCHLEY PL, BRONX, NY 10475-3502
(718) 379-1800
(718) 320-0749
Mailing address
29 CHICKEN VALLEY RD, GLEN HEAD, NY 11545-2103
(718) 379-1800
(516) 759-3033

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
120147
NY
2084P0800X
Psychiatry Physician
Primary
120147
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0039095
GROUP HEALTH INCORPORATED
NY
05
00436668
NY
01
120147
HEALTH INSURANCE PLAN
NY
Enumeration date
01/22/2006
Last updated
09/11/2025
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