Organization
PHYSICAL MEDICINE AND REHABILITATION OF NY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GAUTAM KAUSHIK KHAKHAR M.D. (MEDICAL DIRECTOR)
(718) 549-7260
Entity
Organization
Contact information
Practice address
3815 PUTNAM AVE W, BRONX, NY 10463-2442
(718) 549-7260
Mailing address
9520 QUEENS BLVD, REGO PARK, NY 11374-1136
(718) 459-1280
Taxonomy
Speciality
Code
Description
License number
State
2081S0010X
Sports Medicine (Physical Medicine & Rehabilitation) Physician
Primary
218201
NY
Other
Enumeration date
03/14/2007
Last updated
08/22/2020
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