Healthcare Provider Details

I. General information

NPI: 1346310760
Provider Name (Legal Business Name): SANDHYA KATZ M.B.B.S
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: SANDHYA GOPALAKRISHNA GANTI M.B.B.S

II. Dates (important events)

Enumeration Date: 11/09/2006
Last Update Date: 11/11/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5645 MAIN ST DEPARTMENT OF EMERGENCY MEDICINE
FLUSHING NY
11355-5045
US

IV. Provider business mailing address

285 BULSONTOWN RD
STONY POINT NY
10980-3315
US

V. Phone/Fax

Practice location:
  • Phone: 718-670-1426
  • Fax:
Mailing address:
  • Phone: 917-621-5736
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0204X
TaxonomyPediatric Emergency Medicine (Pediatrics) Physician
License Number199894
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number199894
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: