Individual
ANMOL GUPTA BANSAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1468 MADISON AVE, NEW YORK, NY 10029-6508
(732) 208-1415
Mailing address
719 NORTHVIEW ST, BELLINGHAM, WA 98226-4600
(732) 208-1415
Taxonomy
Speciality
Code
Description
License number
State
2085N0700X
Neuroradiology Physician
0101266358
VA
2085R0202X
Diagnostic Radiology Physician
Primary
289216-01
NY
2085R0202X
Diagnostic Radiology Physician
61323091
WA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/19/2013
Last updated
12/01/2022
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