Healthcare Provider Details

I. General information

NPI: 1891322368
Provider Name (Legal Business Name): NAMRATA VIVEK GUMASTE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/25/2020
Last Update Date: 07/30/2025
Certification Date: 07/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

222 E 41ST ST FL 23
NEW YORK NY
10017-6739
US

IV. Provider business mailing address

222 E 41ST ST # 23
NEW YORK NY
10017-6739
US

V. Phone/Fax

Practice location:
  • Phone: 212-481-1350
  • Fax:
Mailing address:
  • Phone: 212-481-1350
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License Number323215
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: