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General NPI Number Information
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NPI Number | 1154682722
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Entity Type | Individual
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Provider Name | MICHELLE NAOMI GONTA M.D.
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Gender | Female
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Dates
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Enumeration Date | 05/31/2012
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Last Update Date | 09/16/2022
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Provider Practice Location Address
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Address Line | 550 1ST AVE NYU LANGONE MEDICAL CENTER
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City | NEW YORK
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State | NY
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Zip | 10016-6402
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Country | US
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Telephone | 212-263-5506
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Fax |
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Provider Business Mailing Address
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Address Line | 429 E 73RD ST APT 3FE
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City | NEW YORK
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State | NY
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Zip | 10021-9501
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Country | US
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Telephone | 201-321-4839
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 274364
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License Number State | NY
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