Individual
PRANISHA GAUTAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1025 LAKEVILLE RD, NEW HYDE PARK, NY 11040-3041
(917) 723-1546
Mailing address
506 6TH ST, BROOKLYN, NY 11215-3609
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
268347
NY
Other
Enumeration date
02/04/2011
Last updated
06/14/2023
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