=====================================================
General NPI Number Information
=====================================================
NPI Number | 1922274166
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | SUBHASH C. GULATI, MD PC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/07/2008
-----------------------------------------------------
Last Update Date | 05/07/2008
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 331 E 65TH ST
-----------------------------------------------------
City | NEW YORK
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 10065-6881
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 212-535-1514
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 250 BROADVIEW AVE
-----------------------------------------------------
City | NEW ROCHELLE
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 10804-4145
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 914-837-4859
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | SUBHASH CHANDER GULATI
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 212-535-1514
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207RH0003X
-----------------------------------------------------
Taxonomy Name | Hematology & Oncology Physician
-----------------------------------------------------
License Number | 131569
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------