Provider Demographics
NPI:1538456322
Name:GOWDA, VINAYAK SREENIVAS (MD, MRCS,)
Entity Type:Individual
Prefix:DR
First Name:VINAYAK
Middle Name:SREENIVAS
Last Name:GOWDA
Suffix:
Gender:M
Credentials:MD, MRCS,
Other - Prefix:DR
Other - First Name:VINAYAK
Other - Middle Name:
Other - Last Name:SREENIVAS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD, MRCS,
Mailing Address - Street 1:1276 FULTON AVE
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10456-3402
Mailing Address - Country:US
Mailing Address - Phone:718-992-7669
Mailing Address - Fax:
Practice Address - Street 1:1650 SELWYN AVE
Practice Address - Street 2:DEPARTMENT OF SURGERY, 4TH FLOOR
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10457-7626
Practice Address - Country:US
Practice Address - Phone:718-960-1216
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-30
Last Update Date:2018-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY295882208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery