Healthcare Provider Details

I. General information

NPI: 1225250715
Provider Name (Legal Business Name): ARUNDHATI BIKASH GOSWAMI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/03/2007
Last Update Date: 11/09/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

984455 NEBRASKA MEDICAL CTR
OMAHA NE
68198-4455
US

IV. Provider business mailing address

13330 LARIMORE AVE #303
OMAHA NE
68164-6327
US

V. Phone/Fax

Practice location:
  • Phone: 402-552-2000
  • Fax:
Mailing address:
  • Phone: 402-502-4326
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207LP3000X
TaxonomyPediatric Anesthesiology Physician
License Number5493
License Number StateNE
# 2
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number11263
License Number StateND

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: