Provider Demographics
NPI:1952402794
Name:S K GULATI MD PC
Entity Type:Organization
Organization Name:S K GULATI MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SUDARSHAN
Authorized Official - Middle Name:K
Authorized Official - Last Name:GULATI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:716-634-4798
Mailing Address - Street 1:338 HARRIS HILL RD
Mailing Address - Street 2:SUITE 207
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14221-7407
Mailing Address - Country:US
Mailing Address - Phone:716-634-4798
Mailing Address - Fax:716-634-0987
Practice Address - Street 1:338 HARRIS HILL RD
Practice Address - Street 2:SUITE 207
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14221-7407
Practice Address - Country:US
Practice Address - Phone:716-634-4798
Practice Address - Fax:716-634-0987
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-26
Last Update Date:2008-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY122047-1207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00602479Medicaid
NY000506593004OtherBLUE CROSS
NY2008188OtherINDEPENDENT HEALTH
NY000506593004OtherBLUE CROSS
NY2008188OtherINDEPENDENT HEALTH