Provider Demographics
NPI:1831847946
Name:GOSWAMI, SUMANTA (PHD)
Entity type:Individual
Prefix:DR
First Name:SUMANTA
Middle Name:
Last Name:GOSWAMI
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:150 NEW SCOTLAND AVE
Mailing Address - Street 2:4104, CENTER FOR MEDICAL SCIENCE
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12208-3423
Mailing Address - Country:US
Mailing Address - Phone:134-761-3332
Mailing Address - Fax:
Practice Address - Street 1:150 NEW SCOTLAND AVE
Practice Address - Street 2:4104, CENTER FOR MEDICAL SCIENCE
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12208-3423
Practice Address - Country:US
Practice Address - Phone:134-761-3332
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-17
Last Update Date:2022-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246Z00000XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, Other