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General NPI Number Information
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NPI Number | 1649064965
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Entity Type | Individual
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Provider Name | AVANI GHONGE
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Gender | Female
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Dates
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Enumeration Date | 04/09/2025
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Last Update Date | 04/11/2025
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Provider Practice Location Address
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Address Line | 200 HAWKINS DR
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City | IOWA CITY
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State | IA
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Zip | 52242-1009
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Country | US
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Telephone | 319-356-1338
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Fax |
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Provider Business Mailing Address
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Address Line | 33067 LAKE MICHIGAN ST
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City | FREMONT
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State | CA
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Zip | 94555-1282
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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 | 207LC0200X
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Taxonomy Name | Critical Care Medicine (Anesthesiology) Physician
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License Number | R-13375
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License Number State | IA
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