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NPI Code Detail

MEDICARE: ANIL SANGWAN M.D.

MEDICARE: ANIL SANGWAN 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
1207R00000XInternal Medicine Physician214406NY

General Provider Information

NPI Number : 1083728323
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANIL SANGWAN M.D.
Provider Business Mailing Address
First Line : 116 TERRYVILLE RD
Second Line :
City : PORT JEFFERSON STATION
State : NY
Zip : 11776-1329
Country : US
Telephone Number : 631-928-2002
Fax Number : 631-473-4427
Provider Business Practice Location Address
First Line : 116 TERRYVILLE RD
Second Line :
City : PORT JEFFERSON STATION
State : NY
Zip : 11776-1329
Country : US
Telephone Number : 631-928-2002
Fax Number : 631-473-4427
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/17/2006
Last Update Date : 10/26/2010

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1346280658 — SANJAY SANGWAN M.D.
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11776-1329
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Practice Fax: 631-473-4427

Directions to “ ANIL SANGWAN M.D.” Practice Location

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