Individual
DR. GAUTAM KAUSHIK KHAKHAR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3815 PUTNAM AVE W, BRONX, NY 10463-2442
(718) 549-7260
Mailing address
171 E 84TH ST, APT 21J, NEW YORK, NY 10028-2000
(917) 208-6877
Taxonomy
Speciality
Code
Description
License number
State
2081S0010X
Sports Medicine (Physical Medicine & Rehabilitation) Physician
Primary
218201
NY
Other
Enumeration date
03/13/2007
Last updated
07/08/2007
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