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Contact Information

PRANISHA GAUTAM
1025 LAKEVILLE RD
NEW HYDE PARK, NY11040-3041
 Phone: 917-723-1546
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Infectious Disease

207RI0200X 11 Physician/Internal Medicine
Indicates primary specialty

NPI Profile & details for PRANISHA GAUTAM · (Female)

NPI # 1841596103
Status Active
Credentials
Entity Individual
Enumeration date 02/04/2011
Last updated 06/14/2023 - About 3 years ago
Sole proprietor 1 Yes
Identifiers
  • NY License # 268347
Hospital affiliation(s)
  • LONG ISLAND JEWISH MEDICAL CENTER - (Acute Care)
    270 - 05 76TH AVENUE
    NEW HYDE PARK, NY 11040
  • NORTH SHORE UNIVERSITY HOSPITAL - (Acute Care)
    300 COMMUNITY DRIVE
    MANHASSET, NY 11030
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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