Ganguly, Gautam
Ganguly, Gautam is an sole proprietor health care provider with primary practice located at 1542 Kingsley Ave Ste 146 , Orange Park FL 32073-4547. He recently has only one registered license in Allopathic & Osteopathic Physicians / General Practice, which is considered as his primary health care specialty. Ganguly, Gautam can be contacted via phone (904) 269-2990.Contact Information
Primary practice address
1542 Kingsley Ave Ste 146
Orange Park FL 32073-4547
Phone: (904) 269-2990
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / General Practice | 208D00000X | ACN1448 | Florida |
| Allopathic & Osteopathic Physicians / General Practice | 208D00000X | 019167 | Puerto Rico |
Profile Details
| NPI number | 1669849824 |
|---|---|
| LBN Legal business name | Ganguly, Gautam |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Aug 24th, 2015 |
| Last updated | Jul 19th, 2022 - about 2 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
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