Provider Demographics
NPI:1578121430
Name:GOGOKHIA, LASHA (MD)
Entity Type:Individual
Prefix:DR
First Name:LASHA
Middle Name:
Last Name:GOGOKHIA
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 1:435 E 70TH ST APT 25A
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10021-5348
Mailing Address - Country:US
Mailing Address - Phone:646-577-7653
Mailing Address - Fax:
Practice Address - Street 1:1283 YORK AVENUE,
Practice Address - Street 2:9TH FL
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021
Practice Address - Country:US
Practice Address - Phone:929-746-0707
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-04
Last Update Date:2023-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY319205207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine