MEDICARE: ABHISHEK PANDEY MD

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	207QS1201X	Sleep Medicine (Family Medicine) Physician	293427	NY
2	207QS1201X	Sleep Medicine (Family Medicine) Physician	MD469969	PA

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	:	1265786990
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ABHISHEK PANDEY MD

Provider Business Mailing Address
First Line	:	92 GREENWAY DR
Second Line	:
City	:	STATEN ISLAND
State	:	NY
Zip	:	10301-3366
Country	:	US
Telephone Number	:	718-287-5337
Fax Number	:	718-703-9244

Provider Business Practice Location Address
First Line	:	1302 NEW YORK AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11203-5508
Country	:	US
Telephone Number	:	347-559-0133
Fax Number	:

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

Provider Enumeration Date	:	11/02/2012
Last Update Date	:	02/22/2021

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