Provider Demographics
NPI:1568798650
Name:GHISTA, ANAMIKA D (MD)
Entity Type:Individual
Prefix:DR
First Name:ANAMIKA
Middle Name:D
Last Name:GHISTA
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 1:885 3RD AVE
Mailing Address - Street 2:C/O LATHAM & WATKINS LLP
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10022-4834
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:885 3RD AVE
Practice Address - Street 2:C/O LATHAM & WATKINS LLP
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10022-4834
Practice Address - Country:US
Practice Address - Phone:212-906-1200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-23
Last Update Date:2010-04-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY254151-1207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine