MEDICARE: GOPAL SUKHRAJ PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363A00000X	Physician Assistant	006695	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1134170731
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GOPAL SUKHRAJ PA

Provider Business Mailing Address
First Line	:	80 MARCUS DRIVE
Second Line	:	JAMAICA HOSPITAL EMERGENCY DEPT
City	:	MELVILLE
State	:	NY
Zip	:	11747
Country	:	US
Telephone Number	:	631-391-7700
Fax Number	:	631-454-4161

Provider Business Practice Location Address
First Line	:	8900 VAN WYCK EXPY
Second Line	:	JAMAICA HOSPITAL EMERGENCY DEPT
City	:	JAMAICA
State	:	NY
Zip	:	11418-2897
Country	:	US
Telephone Number	:	718-206-8918
Fax Number	:	631-454-4161

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/16/2006
Last Update Date	:	07/08/2007

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Directions to “ GOPAL SUKHRAJ PA” Practice Location

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