Healthcare Provider Details

I. General information

NPI: 1467985044
Provider Name (Legal Business Name): ANKIT KANSAL M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/10/2017
Last Update Date: 08/19/2022
Certification Date: 08/19/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3119 NEWTOWN AVE STE 201
ASTORIA NY
11102-1392
US

IV. Provider business mailing address

660 WHITE PLAINS RD STE 400
TARRYTOWN NY
10591-5107
US

V. Phone/Fax

Practice location:
  • Phone: 718-971-2490
  • Fax:
Mailing address:
  • Phone: 914-984-2546
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number318274
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: