Provider Demographics
NPI:1235422635
Name:FLEISCHMAN, GITANJALI MADAN (MD)
Entity Type:Individual
Prefix:
First Name:GITANJALI
Middle Name:MADAN
Last Name:FLEISCHMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:GITANJALI
Other - Middle Name:
Other - Last Name:MADAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:2920 HIGHWOODS BLVD
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27604-0010
Mailing Address - Country:US
Mailing Address - Phone:877-498-4490
Mailing Address - Fax:
Practice Address - Street 1:3024 NEW BERN AVE STE 307
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27610
Practice Address - Country:US
Practice Address - Phone:919-350-7856
Practice Address - Fax:919-235-6592
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-18
Last Update Date:2022-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2018-01555207Y00000X
NC173861390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Multi-Specialty
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training ProgramGroup - Multi-Specialty