Provider Demographics
NPI:1780641217
Name:KUNDU, GARGI (MD)
Entity Type:Individual
Prefix:DR
First Name:GARGI
Middle Name:
Last Name:KUNDU
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:GARGI
Other - Middle Name:
Other - Last Name:CHAKRABARTY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:700 LAKE AVE
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:NH
Mailing Address - Zip Code:03103-2734
Mailing Address - Country:US
Mailing Address - Phone:603-263-6293
Mailing Address - Fax:603-621-4016
Practice Address - Street 1:700 LAKE AVE
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03103-2734
Practice Address - Country:US
Practice Address - Phone:603-263-6293
Practice Address - Fax:603-621-4016
Is Sole Proprietor?:No
Enumeration Date:2006-04-27
Last Update Date:2020-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH11900207RA0401X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RA0401XAllopathic & Osteopathic PhysiciansInternal MedicineAddiction Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA110083055AMedicaid
MA1780641217OtherMEDICARE LEGACY