Provider Demographics
NPI:1205924164
Name:ASHVANI K GULATI MD PC
Entity type:Organization
Organization Name:ASHVANI K GULATI MD PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:SURGICAL COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:TRACEY
Authorized Official - Middle Name:D
Authorized Official - Last Name:PICI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:716-874-2455
Mailing Address - Street 1:3750 DELAWARE AVE
Mailing Address - Street 2:
Mailing Address - City:KENMORE
Mailing Address - State:NY
Mailing Address - Zip Code:14217-1002
Mailing Address - Country:US
Mailing Address - Phone:716-874-2455
Mailing Address - Fax:716-874-5775
Practice Address - Street 1:3750 DELAWARE AVE
Practice Address - Street 2:
Practice Address - City:KENMORE
Practice Address - State:NY
Practice Address - Zip Code:14217-1002
Practice Address - Country:US
Practice Address - Phone:716-874-2455
Practice Address - Fax:716-874-5775
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-10
Last Update Date:2025-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM01241950Medicaid
NYRA4583Medicare ID - Type UnspecifiedFRANCESCO J BARBAROSSA OD
NY029483Medicare ID - Type UnspecifiedMEDICARE GROUP #
NM01241950Medicaid
NYE75728Medicare UPIN
NYB29483Medicare ID - Type UnspecifiedASHVANI K. GULATI MD