Provider Demographics
NPI:1235343393
Name:GANGOPADHYAY, MAALOBEEKA (MD)
Entity Type:Individual
Prefix:
First Name:MAALOBEEKA
Middle Name:
Last Name:GANGOPADHYAY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3959 BROADWAY # B6N
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10032-1559
Mailing Address - Country:US
Mailing Address - Phone:615-327-7000
Mailing Address - Fax:615-322-1578
Practice Address - Street 1:3959 BROADWAY # B6N
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10032-1559
Practice Address - Country:US
Practice Address - Phone:615-327-7000
Practice Address - Fax:615-322-1578
Is Sole Proprietor?:No
Enumeration Date:2007-05-09
Last Update Date:2018-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2464812084P0800X, 2084P0804X
TNMD00000484652084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry