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General NPI Number Information
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NPI Number | 1780553677
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Entity Type | Individual
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Provider Name | GAUTAM AHLUWALIA MD
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Gender | Male
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Dates
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Enumeration Date | 10/30/2025
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Last Update Date | 11/07/2025
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Provider Practice Location Address
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Address Line | 1872 COMMERCE ST
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City | YORKTOWN HEIGHTS
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State | NY
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Zip | 10598-4430
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Country | US
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Telephone | 914-962-3303
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Fax | 914-962-4271
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Provider Business Mailing Address
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Address Line | 667 STONELEIGH AVE STE A201
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City | CARMEL
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State | NY
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Zip | 10512-2454
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Country | US
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Telephone | 845-278-5223
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Fax | 845-278-4579
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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 | 339937
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License Number State | NY
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