MEDICARE: DR. BHISHAM GARG M.D.

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	207R00000X	Internal Medicine Physician	207381	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
2	207381	OTHER	NM	STATE LICENSE

General Provider Information

NPI Number	:	1356366728
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BHISHAM GARG M.D.

Provider Business Mailing Address
First Line	:	4 OXFORD XING
Second Line	:	SUITE 103, BUILDING 4
City	:	NEW HARTFORD
State	:	NY
Zip	:	13413-3248
Country	:	US
Telephone Number	:	315-792-9933
Fax Number	:	315-792-9925

Provider Business Practice Location Address
First Line	:	4 OXFORD XING
Second Line	:	SUITE 103, BUILDING 4
City	:	NEW HARTFORD
State	:	NY
Zip	:	13413-3248
Country	:	US
Telephone Number	:	315-792-9933
Fax Number	:	315-792-9925

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

Provider Enumeration Date	:	07/13/2006
Last Update Date	:	07/23/2014

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