Provider Demographics
NPI:1346402427
Name:GATHA, NEHAL (MD)
Entity Type:Individual
Prefix:
First Name:NEHAL
Middle Name:
Last Name:GATHA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 PORT WASHINGTON BLVD
Mailing Address - Street 2:NEW YORK CARDIOVASCULAR ANESTHESIOLOGISTS, P.C
Mailing Address - City:ROSLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11576-1347
Mailing Address - Country:US
Mailing Address - Phone:516-627-6624
Mailing Address - Fax:516-627-3804
Practice Address - Street 1:100 PORT WASHINGTON BLVD
Practice Address - Street 2:NEW YORK CARDIOVASCULAR ANESTHESIOLOGISTS, P.C
Practice Address - City:ROSLYN
Practice Address - State:NY
Practice Address - Zip Code:11576-1347
Practice Address - Country:US
Practice Address - Phone:516-627-6624
Practice Address - Fax:516-627-3804
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-30
Last Update Date:2014-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY261923207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYA400070621Medicare PIN