Provider Demographics
NPI:1023179629
Name:MALHOTRA, GULSHAN K (MD)
Entity Type:Individual
Prefix:
First Name:GULSHAN
Middle Name:K
Last Name:MALHOTRA
Suffix:
Gender:F
Credentials:MD
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Other - Credentials:
Mailing Address - Street 1:9229 QUEENS BLVD
Mailing Address - Street 2:1H
Mailing Address - City:REGO PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11374-1056
Mailing Address - Country:US
Mailing Address - Phone:718-830-9000
Mailing Address - Fax:718-897-0449
Practice Address - Street 1:9229 QUEENS BLVD
Practice Address - Street 2:1H
Practice Address - City:REGO PARK
Practice Address - State:NY
Practice Address - Zip Code:11374-1056
Practice Address - Country:US
Practice Address - Phone:718-830-9000
Practice Address - Fax:718-897-0449
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-13
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
NY148316207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYB17656Medicare UPIN