Individual
ICHCHA GOSWAMY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
300 BAY SHORE RD, NORTH BABYLON, NY 11703-2823
(631) 586-2700
(631) 586-3524
Mailing address
1000 ZECKENDORF BLVD, GARDEN CITY, NY 11530-2133
(516) 542-6880
(526) 542-5556
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
136782
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00941497
—
NY
Enumeration date
05/19/2006
Last updated
10/08/2011
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