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NPI Code Detail

MEDICARE: DR. SANJAY K. JAIN M.D.

MEDICARE: DR. SANJAY K. JAIN 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
12084N0400XNeurology Physician182734NY

General Provider Information

NPI Number : 1306988290
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. SANJAY K. JAIN M.D.
Provider Business Mailing Address
First Line : PO BOX 957
Second Line :
City : GLENWOOD LANDING
State : NY
Zip : 11547-0957
Country : US
Telephone Number : 646-801-9234
Fax Number :
Provider Business Practice Location Address
First Line : 26619 UNION TPKE
Second Line :
City : NEW HYDE PARK
State : NY
Zip : 11040-1426
Country : US
Telephone Number : 516-900-2520
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/14/2007
Last Update Date : 11/12/2013

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