SUDARSHAN GAUTAM
NPI 1245802024
Student in an Organized Health Care Education/Training Program in Brooklyn, NY

Active since July 12, 2021
4802 10TH AVE, BROOKLYN, NY 11219(718) 283-6000 Get Directions Write a Review

NPPES record last updated: July 12, 2021. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Sudarshan Gautam NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SUDARSHAN GAUTAM (NPI 1245802024) is an individual student in an organized health care education/training program in Brooklyn, New York and active in the NPI registry since July 2021.

NPPES Registry Identity

NPI1245802024
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameSUDARSHAN GAUTAM
Location Address4802 10TH AVEBrooklyn, NY 11219-2916
Mailing Address4802 10th AveBrooklyn, NY 11219-2916 · (718) 283-6000
Sole ProprietorYes
Enumeration DateJuly 12, 2021
NPPES CertifiedJuly 12, 2021
NPI 1245802024 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Taxonomy Code390200000X
Definition

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

4802 10TH AVE, Brooklyn, NY 11219

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Legal Medicine
4802 10TH AVE
BROOKLYN, NY 11219
Nurse Practitioner (Psychiatric/Mental Health)
4802 10TH AVE
BROOKLYN, NY 11219
Student in an Organized Health Care Education/Training Program
4802 10TH AVE
BROOKLYN, NY 11219
Student in an Organized Health Care Education/Training Program
4802 10TH AVE
BROOKLYN, NY 11219
Student in an Organized Health Care Education/Training Program
4802 10TH AVE
BROOKLYN, NY 11219
Student in an Organized Health Care Education/Training Program
4802 10TH AVE
BROOKLYN, NY 11219
Nurse Practitioner (Family)
4802 10TH AVE, PRE-TESTING
BROOKLYN, NY 11219
Internal Medicine (Infectious Disease)
4802 10TH AVE
BROOKLYN, NY 11219

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Sudarshan Gautam's NPI number?

The NPI number for Sudarshan Gautam is 1245802024. It was assigned to this individual provider in the NPPES registry on July 12, 2021.

Where is Sudarshan Gautam located?

Sudarshan Gautam practices at 4802 10th Ave, Brooklyn, NY 11219. The listed phone number is (718) 283-6000.

What is Sudarshan Gautam's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

When was this NPI record last updated?

The NPPES record for Sudarshan Gautam was last updated on July 12, 2021. NPI Profile syncs with the weekly NPPES data releases published by CMS.