Provider Demographics
NPI:1871945022
Name:GOGNA, SHEKHAR
Entity type:Individual
Prefix:
First Name:SHEKHAR
Middle Name:
Last Name:GOGNA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:SHEKHAR
Other - Middle Name:
Other - Last Name:GOGNA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MBBS
Mailing Address - Street 1:42 N PERKINS AVE
Mailing Address - Street 2:
Mailing Address - City:ELMSFORD
Mailing Address - State:NY
Mailing Address - Zip Code:10523-3211
Mailing Address - Country:US
Mailing Address - Phone:718-427-1437
Mailing Address - Fax:
Practice Address - Street 1:42 N PERKINS AVE
Practice Address - Street 2:
Practice Address - City:ELMSFORD
Practice Address - State:NY
Practice Address - Zip Code:10523-3211
Practice Address - Country:US
Practice Address - Phone:718-427-1437
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-11
Last Update Date:2016-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ZZ36946208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery