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General NPI Number Information
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NPI Number | 1932689940
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Entity Type | Organization
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Legal Business Name | GOSWAMI DENTAL CARE PC
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Dates
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Enumeration Date | 08/19/2018
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Last Update Date | 08/19/2018
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Provider Practice Location Address
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Address Line | 119 W 57TH ST STE 700
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City | NEW YORK
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State | NY
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Zip | 10019-2303
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Country | US
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Telephone | 917-546-3041
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Fax |
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Provider Business Mailing Address
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Address Line | 62 E 118TH ST APT 1
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City | NEW YORK
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State | NY
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Zip | 10035-4679
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Country | US
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Telephone | 917-546-3041
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Fax |
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Authorized Official
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Title or Position | DENTIST
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Name | DR. MANISHA GOSWAMI
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Credential | DMD
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Telephone | 917-981-5342
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 056507-1
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License Number State | NY
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