Provider Demographics
NPI:1427016088
Name:SHRIKHANDE, GAUTAM V (MD)
Entity Type:Individual
Prefix:
First Name:GAUTAM
Middle Name:V
Last Name:SHRIKHANDE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:5645 MAIN ST
Mailing Address - Street 2:W-LL300
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11355-5045
Mailing Address - Country:US
Mailing Address - Phone:718-303-6100
Mailing Address - Fax:718-939-1167
Practice Address - Street 1:5645 MAIN ST
Practice Address - Street 2:W-LL300
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11355-5045
Practice Address - Country:US
Practice Address - Phone:718-303-6100
Practice Address - Fax:718-939-1167
Is Sole Proprietor?:No
Enumeration Date:2006-05-03
Last Update Date:2014-11-04
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY2491532086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery