Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207L00000X | Anesthesiologist | 109010 | NY |
NPI | 1013156934 |
---|---|
Provider Name | Dr. Gopal A Bhandarkar |
First Address | East Patchogue, NY 11772-4800 |
Second Address | East Patchogue, NY 11772-8809 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/02/2009 |
Last Update Date | 17/02/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
B19560 | (02) | NY |