Healthcare Provider Details

I. General information

NPI: 1407678923
Provider Name (Legal Business Name): JOHER SHEIKH PA STUDENT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/28/2024
Last Update Date: 05/10/2026
Certification Date: 05/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

701 N BROADWAY
SLEEPY HOLLOW NY
10591-1020
US

IV. Provider business mailing address

15 BANK ST APT 118L
WHITE PLAINS NY
10606-7017
US

V. Phone/Fax

Practice location:
  • Phone: 914-366-3000
  • Fax:
Mailing address:
  • Phone: 631-398-5054
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: