Provider Demographics
NPI:1114900669
Name:GANGOPADHYAY, REKHA C (MD)
Entity Type:Individual
Prefix:DR
First Name:REKHA
Middle Name:C
Last Name:GANGOPADHYAY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:REKHA
Other - Middle Name:
Other - Last Name:CHAKRABARTI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MBBS
Mailing Address - Street 1:6 HUNTING HILL RD
Mailing Address - Street 2:
Mailing Address - City:NEW HYDE PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11040-3709
Mailing Address - Country:US
Mailing Address - Phone:516-873-1648
Mailing Address - Fax:
Practice Address - Street 1:10 COMMERCE DR
Practice Address - Street 2:
Practice Address - City:NEW ROCHELLE
Practice Address - State:NY
Practice Address - Zip Code:10801-5214
Practice Address - Country:US
Practice Address - Phone:914-637-2063
Practice Address - Fax:914-365-6307
Is Sole Proprietor?:No
Enumeration Date:2005-11-29
Last Update Date:2013-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY152675207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00852873Medicaid
NY00852873Medicaid
NYB12326Medicare UPIN
NY29D30YRXP1Medicare PIN
NY29D30ZXWW1Medicare PIN
NY29D302Medicare PIN