Provider Demographics
NPI:1639878994
Name:HAMSA GANGASWAMAIAH MD INC
Entity Type:Organization
Organization Name:HAMSA GANGASWAMAIAH MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:GANGASWAMAIAH
Authorized Official - Middle Name:
Authorized Official - Last Name:HAMSA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:201-920-2304
Mailing Address - Street 1:1555 RUTH RD STE 6
Mailing Address - Street 2:
Mailing Address - City:NORTH BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08902-4074
Mailing Address - Country:US
Mailing Address - Phone:732-821-9200
Mailing Address - Fax:732-821-9202
Practice Address - Street 1:1555 RUTH RD STE 6
Practice Address - Street 2:
Practice Address - City:NORTH BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08902-4074
Practice Address - Country:US
Practice Address - Phone:732-821-9200
Practice Address - Fax:732-821-9202
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-27
Last Update Date:2023-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care