Provider Demographics
NPI:1811986458
Name:GHEEWALA, ANUP R (MD)
Entity type:Individual
Prefix:
First Name:ANUP
Middle Name:R
Last Name:GHEEWALA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2818 OCEAN AVE
Mailing Address - Street 2:SUITE#7
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11235-3170
Mailing Address - Country:US
Mailing Address - Phone:718-616-2330
Mailing Address - Fax:718-332-2923
Practice Address - Street 1:2818 OCEAN AVE
Practice Address - Street 2:SUITE#7
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11235-3170
Practice Address - Country:US
Practice Address - Phone:718-616-2330
Practice Address - Fax:718-332-2923
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-17
Last Update Date:2010-04-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY17624012082S0105X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2082S0105XAllopathic & Osteopathic PhysiciansPlastic SurgerySurgery of the Hand
Provider Identifiers
StateIdentifier IDID TypeIssuer
70H952Medicare ID - Type Unspecified