Provider Demographics
NPI:1598995698
Name:GOTTO, GEOFFREY (BSC (HONS), MD)
Entity Type:Individual
Prefix:
First Name:GEOFFREY
Middle Name:
Last Name:GOTTO
Suffix:
Gender:M
Credentials:BSC (HONS), MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:303 EAST 60TH STREET
Mailing Address - Street 2:#15D
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10022-1520
Mailing Address - Country:US
Mailing Address - Phone:917-940-7774
Mailing Address - Fax:
Practice Address - Street 1:303 E 60TH ST
Practice Address - Street 2:#15D
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10022-1514
Practice Address - Country:US
Practice Address - Phone:917-940-7774
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-07-23
Last Update Date:2009-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYP69655208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology