Provider Demographics
NPI:1982671756
Name:GOSWAMI, SANJEEV J (MD)
Entity Type:Individual
Prefix:
First Name:SANJEEV
Middle Name:J
Last Name:GOSWAMI
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:PO BOX 1177
Mailing Address - Street 2:
Mailing Address - City:NORTHAMPTON
Mailing Address - State:MA
Mailing Address - Zip Code:01061-1177
Mailing Address - Country:US
Mailing Address - Phone:413-586-8443
Mailing Address - Fax:413-586-8443
Practice Address - Street 1:30 LOCUST ST
Practice Address - Street 2:
Practice Address - City:NORTHAMPTON
Practice Address - State:MA
Practice Address - Zip Code:01060-2052
Practice Address - Country:US
Practice Address - Phone:413-582-2105
Practice Address - Fax:413-582-2059
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-01
Last Update Date:2008-05-01
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MA053449207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA11-3745493OtherNORTHEAST HEALTH DIRECT
MA11-3745493OtherCONSOLIDATED
MA11-3745493OtherGREAT-WEST
MA11-3745493OtherPRIVATE HEALTHCARE SYSTEM
MA2103907Medicaid
MA36332OtherHEALTH NEW ENGLAND
MA3943578OtherAETNA
MA637454OtherCONNECTICARE
MA87553OtherCHILDREN'S MED. SECURITY
MA11-3745493OtherNORTH AMERICAN PREFERRED
MA11-3745493OtherPLAN VISTA
MA4161811OtherCIGNA
MA000000030314OtherBMC
MA11-3745493OtherUNICARE-GIC
MA11-3745493OtherNORTHEAST HEALTHCARE ALLI
MAAA35907OtherHARVARD PILGRIM
MA11-3745493OtherNORTH AMERICAN PREFERRED
MA11-3745493OtherPRIVATE HEALTHCARE SYSTEM