Provider Demographics
NPI:1780921759
Name:GURCHARAN BAHIA MD PC
Entity type:Organization
Organization Name:GURCHARAN BAHIA MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:GURCHARAN
Authorized Official - Middle Name:SINGH
Authorized Official - Last Name:BAHIA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-255-6391
Mailing Address - Street 1:PO BOX 640725
Mailing Address - Street 2:
Mailing Address - City:OAKLAND GARDENS
Mailing Address - State:NY
Mailing Address - Zip Code:11364-0725
Mailing Address - Country:US
Mailing Address - Phone:718-255-6391
Mailing Address - Fax:718-255-6392
Practice Address - Street 1:13678 39TH AVE
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11354-5515
Practice Address - Country:US
Practice Address - Phone:212-682-3600
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-11
Last Update Date:2013-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY167500207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty