Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | 204628-2 | NY |
N | 207X00000X | Orthopaedic Surgeon | 215567 | MA |
NPI | 1003806373 |
---|---|
Provider Name | Kaushik Bagchi |
First Address | Albany, NY 12206-1069 |
Second Address | Albany, NY 12206-1069 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/10/2005 |
Last Update Date | 10/06/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0172511 | (05) | MA |
02315846 | (05) | NY |
H53134 | (02) | MA |