Provider Demographics
NPI:1871348706
Name:GHANIE, TSHEGOFATSO KIRSTY (MD)
Entity type:Individual
Prefix:MS
First Name:TSHEGOFATSO
Middle Name:KIRSTY
Last Name:GHANIE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:512 LENOX AVENUE
Mailing Address - Street 2:MP 5-177
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10037
Mailing Address - Country:US
Mailing Address - Phone:212-939-3065
Mailing Address - Fax:212-939-2653
Practice Address - Street 1:512 LENOX AVENUE
Practice Address - Street 2:MP 5-177
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10037
Practice Address - Country:US
Practice Address - Phone:212-939-3065
Practice Address - Fax:212-939-2653
Is Sole Proprietor?:No
Enumeration Date:2024-04-23
Last Update Date:2025-01-07
Deactivation Date:2024-12-23
Deactivation Code:
Reactivation Date:2025-01-07
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program