Healthcare Provider Details

I. General information

NPI: 1427410562
Provider Name (Legal Business Name): GULNAR MANGAT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/28/2016
Last Update Date: 06/17/2024
Certification Date: 06/17/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

560 1ST AVE
NEW YORK NY
10016-6402
US

IV. Provider business mailing address

622 W 168TH ST PH5-133 STEM
NEW YORK NY
10032-3720
US

V. Phone/Fax

Practice location:
  • Phone: 212-263-5072
  • Fax: 212-263-7254
Mailing address:
  • Phone: 212-342-5525
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number309131
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code207LC0200X
TaxonomyCritical Care Medicine (Anesthesiology) Physician
License Number309131
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: