Healthcare Provider Details

I. General information

NPI: 1043141476
Provider Name (Legal Business Name): SANDHIR MAHARAJ PMHNP - BC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/26/2026
Last Update Date: 05/26/2026
Certification Date: 05/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2986 S ROCA ST
GILBERT AZ
85295-1717
US

IV. Provider business mailing address

2986 S ROCA ST
GILBERT AZ
85295-1717
US

V. Phone/Fax

Practice location:
  • Phone: 602-466-8352
  • Fax:
Mailing address:
  • Phone: 602-466-8352
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number2026021016
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: