Healthcare Provider Details

I. General information

NPI: 1376004234
Provider Name (Legal Business Name): SAIKAT GOSWAMI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/25/2019
Last Update Date: 09/17/2025
Certification Date: 09/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4500 PARSONS BLVD
FLUSHING NY
11355-2205
US

IV. Provider business mailing address

5051 N KENMORE AVE APT 401
CHICAGO IL
60640-3143
US

V. Phone/Fax

Practice location:
  • Phone: 718-670-5359
  • Fax:
Mailing address:
  • Phone: 920-903-7440
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0207X
TaxonomyPediatric Hematology & Oncology Physician
License Number318078
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: