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General NPI Number Information
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NPI Number | 1568470912
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Entity Type | Individual
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Provider Name | GAUTAMI GUHA MD, PH. D
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Gender | Female
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Dates
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Enumeration Date | 08/03/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 138 ALBANY POST RD
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City | MONTROSE
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State | NY
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Zip | 10548-1434
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Country | US
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Telephone | 914-737-4400
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Fax |
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Provider Business Mailing Address
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Address Line | 350 SPRAIN RD
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City | SCARSDALE
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State | NY
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Zip | 10583-1222
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Country | US
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Telephone |
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 211584
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License Number State | NY
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