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General NPI Number Information
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NPI Number | 1275117459
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Entity Type | Individual
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Provider Name | NATASHA GAUTAM M.D.
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Gender | Female
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Dates
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Enumeration Date | 05/12/2021
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Last Update Date | 09/27/2024
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Provider Practice Location Address
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Address Line | 1176 MAIN ST
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City | BUFFALO
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State | NY
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Zip | 14209-2102
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Country | US
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Telephone | 716-881-7900
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Fax | 716-677-6507
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Provider Business Mailing Address
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Address Line | 1176 MAIN ST
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City | BUFFALO
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State | NY
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Zip | 14209-2102
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Country | US
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Telephone | 716-881-7900
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Fax | 716-677-6507
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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 | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | 33495
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License Number State | MN
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Taxonomy #2
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Taxonomy Code | 207WX0109X
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Taxonomy Name | Neuro-ophthalmology Physician
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License Number | R-12333
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License Number State | IA
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Taxonomy #3
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Taxonomy Code | 207WX0110X
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Taxonomy Name | Pediatric Ophthalmology and Strabismus Specialist Physician Physician
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License Number | 125.077309
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License Number State | IL
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Taxonomy #4
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Taxonomy Code | 207WX0009X
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Taxonomy Name | Glaucoma Specialist (Ophthalmology) Physician
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License Number | 327685
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License Number State | NY
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