Healthcare Provider Details

I. General information

NPI: 1659509560
Provider Name (Legal Business Name): SOHAG NATVARLAL SANGHANI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/30/2009
Last Update Date: 08/24/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

75-59 263RD STREET
GLEN OAKS NY
11004-1150
US

IV. Provider business mailing address

7559 263RD ST
GLEN OAKS NY
11004-1150
US

V. Phone/Fax

Practice location:
  • Phone: 718-470-5720
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number268945
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code2084P0805X
TaxonomyGeriatric Psychiatry Physician
License Number268945
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: