Healthcare Provider Details

I. General information

NPI: 1518938141
Provider Name (Legal Business Name): SARABJIT SINGH PHOKELA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/31/2006
Last Update Date: 05/29/2020
Certification Date: 05/29/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

150 55TH ST
BROOKLYN NY
11220-2508
US

IV. Provider business mailing address

150 55TH ST
BROOKLYN NY
11220-2508
US

V. Phone/Fax

Practice location:
  • Phone: 718-630-6375
  • Fax: 718-630-6322
Mailing address:
  • Phone: 718-630-6375
  • Fax: 718-630-6322

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number235529
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code2080N0001X
TaxonomyNeonatal-Perinatal Medicine Physician
License NumberMD062854L
License Number StatePA
# 3
Primary TaxonomyY
Taxonomy Code2080N0001X
TaxonomyNeonatal-Perinatal Medicine Physician
License Number235529
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: