Healthcare Provider Details

I. General information

NPI: 1851302483
Provider Name (Legal Business Name): RAHUL SACHDEV D.D.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/10/2006
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

902 COLUMBUS AVE.
NEW YORK NY
10025
US

IV. Provider business mailing address

902 COLUMBUS AVE.
NEW YORK NY
10025-1002
US

V. Phone/Fax

Practice location:
  • Phone: 212-749-5000
  • Fax: 212-749-5522
Mailing address:
  • Phone: 212-444-2544
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number049425
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: