MEDICARE: DR. SARITA KANSAL M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	175096-1	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1073556825
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SARITA KANSAL M.D.

Provider Business Mailing Address
First Line	:	27 HIDDEN PINES CT
Second Line	:
City	:	EAST AMHERST
State	:	NY
Zip	:	14051-1688
Country	:	US
Telephone Number	:	716-568-1414
Fax Number	:

Provider Business Practice Location Address
First Line	:	725 ORCHARD PARK RD
Second Line	:	SUITE B
City	:	WEST SENECA
State	:	NY
Zip	:	14224-3352
Country	:	US
Telephone Number	:	716-674-0101
Fax Number	:	716-712-0767

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/13/2006
Last Update Date	:	06/14/2011

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