Provider Demographics
NPI:1922338631
Name:MAKKAR, GITA (PHYSICIAN ASSISTANT)
Entity Type:Individual
Prefix:
First Name:GITA
Middle Name:
Last Name:MAKKAR
Suffix:
Gender:F
Credentials:PHYSICIAN ASSISTANT
Other - Prefix:
Other - First Name:GITA
Other - Middle Name:
Other - Last Name:RANI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:16203 84TH DR
Mailing Address - Street 2:
Mailing Address - City:JAMAICA
Mailing Address - State:NY
Mailing Address - Zip Code:11432-1703
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:301 N MAIN ST STE 3
Practice Address - Street 2:
Practice Address - City:NEW CITY
Practice Address - State:NY
Practice Address - Zip Code:10956-4021
Practice Address - Country:US
Practice Address - Phone:845-499-2017
Practice Address - Fax:845-499-2018
Is Sole Proprietor?:No
Enumeration Date:2009-12-30
Last Update Date:2023-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY013724363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant