Healthcare Provider Details

I. General information

NPI: 1720570476
Provider Name (Legal Business Name): NIKHITA JAIN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/30/2018
Last Update Date: 05/02/2026
Certification Date: 05/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

70 ATLANTIC AVE
BROOKLYN NY
11201-5501
US

IV. Provider business mailing address

700 HICKSVILLE RD STE 205
BETHPAGE NY
11714-3472
US

V. Phone/Fax

Practice location:
  • Phone: 646-501-7889
  • Fax: 212-754-1223
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number331006
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code207YS0012X
TaxonomySleep Medicine (Otolaryngology) Physician
License Number331006
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: