Provider Demographics
NPI:1942242110
Name:GULATI, NEERA (MD)
Entity Type:Individual
Prefix:DR
First Name:NEERA
Middle Name:
Last Name:GULATI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:655 N FOREST RD
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14221-4964
Mailing Address - Country:US
Mailing Address - Phone:716-830-6543
Mailing Address - Fax:716-810-9480
Practice Address - Street 1:655 N FOREST RD
Practice Address - Street 2:
Practice Address - City:WILLIAMSVILLE
Practice Address - State:NY
Practice Address - Zip Code:14221-4964
Practice Address - Country:US
Practice Address - Phone:716-830-6543
Practice Address - Fax:716-810-9480
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-12
Last Update Date:2022-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY194996207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYG62176Medicare UPIN