Individual
TEJA GANTA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1470 MADISON AVE, NEW YORK, NY 10029-6542
(212) 241-6756
Mailing address
1 GUSTAVE L LEVY PL # 1079, NEW YORK, NY 10029-6504
Taxonomy
Speciality
Code
Description
License number
State
207RX0202X
Medical Oncology Physician
Primary
299284
NY
Other
Enumeration date
03/22/2016
Last updated
08/09/2023
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