Healthcare Provider Details

I. General information

NPI: 1548792591
Provider Name (Legal Business Name): SANKET R GOKHALE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/29/2017
Last Update Date: 09/11/2026
Certification Date: 09/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

90 PRESIDENTIAL PLAZA STE 5010
SYRACUSE NY
13202
US

IV. Provider business mailing address

90 PRESIDENTIAL PLAZA STE 5010
SYRACUSE NY
13202
US

V. Phone/Fax

Practice location:
  • Phone: 315-464-9335
  • Fax: 315-464-9338
Mailing address:
  • Phone: 315-464-9335
  • Fax: 315-464-9338

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number346238
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code207RC0001X
TaxonomyClinical Cardiac Electrophysiology Physician
License Number346238
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: