Individual
DESTINEE SOUBANNARATH GWEE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
525 E 68TH ST, NEW YORK, NY 10065-4870
(212) 746-5454
Mailing address
525 E 68TH ST, NEW YORK, NY 10065-4870
(212) 746-5454
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
036.173686
IL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/29/2021
Last updated
03/03/2026
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