Provider Demographics
NPI:1942306568
Name:GANGASANI, VEENA SANKAPPANAVAR (MD)
Entity Type:Individual
Prefix:
First Name:VEENA
Middle Name:SANKAPPANAVAR
Last Name:GANGASANI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:VEENA
Other - Middle Name:HANAMANTAGOUDA
Other - Last Name:SANKAPPANAVAR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:110 S BEDFORD RD
Mailing Address - Street 2:CAREMOUNT MEDICAL PC
Mailing Address - City:MOUNT KISCO
Mailing Address - State:NY
Mailing Address - Zip Code:10549-3446
Mailing Address - Country:US
Mailing Address - Phone:914-241-1050
Mailing Address - Fax:914-242-1516
Practice Address - Street 1:60 MERRITT BLVD
Practice Address - Street 2:
Practice Address - City:FISHKILL
Practice Address - State:NY
Practice Address - Zip Code:12524-2990
Practice Address - Country:US
Practice Address - Phone:845-231-5600
Practice Address - Fax:845-231-5489
Is Sole Proprietor?:No
Enumeration Date:2006-09-15
Last Update Date:2016-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY229829208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02962283Medicaid
NYA400051375Medicare PIN