Provider Demographics
NPI:1114011780
Name:GANESH KARIM MD
Entity Type:Organization
Organization Name:GANESH KARIM MD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LALITHA
Authorized Official - Middle Name:
Authorized Official - Last Name:GANESH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-271-3344
Mailing Address - Street 1:97-30 57TH AVE.
Mailing Address - Street 2:SUITE 1K
Mailing Address - City:CORONA
Mailing Address - State:NY
Mailing Address - Zip Code:11368
Mailing Address - Country:US
Mailing Address - Phone:718-271-3344
Mailing Address - Fax:718-760-4851
Practice Address - Street 1:97-30 57TH AVE.
Practice Address - Street 2:SUITE 1K
Practice Address - City:CORONA
Practice Address - State:NY
Practice Address - Zip Code:11368
Practice Address - Country:US
Practice Address - Phone:718-271-3344
Practice Address - Fax:718-760-4851
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY155042208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty