Healthcare Provider Details

I. General information

NPI: 1245520014
Provider Name (Legal Business Name): HARDIK DOSHI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/14/2011
Last Update Date: 04/28/2020
Certification Date: 04/28/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

215 E 72ND ST
NEW YORK NY
10021-4561
US

IV. Provider business mailing address

373 ETON RD
FRANKLIN SQUARE NY
11010-3421
US

V. Phone/Fax

Practice location:
  • Phone: 470-222-6748
  • Fax:
Mailing address:
  • Phone: 516-242-7199
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2082S0099X
TaxonomyPlastic Surgery Within the Head and Neck (Plastic Surgery) Physician
License Number2905791
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: