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General NPI Number Information
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NPI Number | 1114184173
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Entity Type | Individual
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Provider Name | SARGAM JAIN M.D.
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Gender | Female
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Dates
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Enumeration Date | 05/19/2008
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Last Update Date | 02/18/2020
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Provider Practice Location Address
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Address Line | 31 WEST 10TH STREET SUITE 2C
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City | NEW YORK
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State | NY
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Zip | 10011
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Country | US
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Telephone | 212-677-2985
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Fax | 347-478-5068
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Provider Business Mailing Address
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Address Line | 11 5TH AVE OFC 7
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City | NEW YORK
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State | NY
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Zip | 10003-4342
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Country | US
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Telephone | 917-318-3691
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Fax | 347-478-5068
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 247098
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License Number State | NY
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