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General NPI Number Information
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NPI Number | 1477533644
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Entity Type | Individual
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Provider Name | BIMALENDU GANGULY M.D.
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Gender | Male
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Dates
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Enumeration Date | 01/22/2006
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 140 BENCHLEY PL
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City | BRONX
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State | NY
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Zip | 10475-3502
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Country | US
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Telephone | 718-379-1800
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Fax | 718-320-0749
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Provider Business Mailing Address
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Address Line | 29 CHICKEN VALLEY RD
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City | GLEN HEAD
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State | NY
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Zip | 11545-2103
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Country | US
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Telephone | 718-379-1800
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Fax | 516-759-3033
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 120147
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 120147
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License Number State | NY
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