Provider Demographics
NPI:1275891491
Name:GANGULY, SONALI (MD)
Entity Type:Individual
Prefix:DR
First Name:SONALI
Middle Name:
Last Name:GANGULY
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 1:7019 SHORE RD
Mailing Address - Street 2:2N
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11209-1045
Mailing Address - Country:US
Mailing Address - Phone:917-623-7849
Mailing Address - Fax:
Practice Address - Street 1:150 55TH ST
Practice Address - Street 2:NYU LUTHERAN MEDICAL CENTER DEPT OF EMERGENCY MEDICINE
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11220-2508
Practice Address - Country:US
Practice Address - Phone:718-630-6993
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-04-25
Last Update Date:2015-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY280491207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine