MEDICARE: DR. SONAL BALMUKUND JANI 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	207RC0000X	Cardiovascular Disease Physician	223394-1	NY

General Provider Information

NPI Number	:	1386759116
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SONAL BALMUKUND JANI M.D.,

Provider Business Mailing Address
First Line	:	PO BOX 95000-2449
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19195-2449
Country	:	US
Telephone Number	:	718-752-7280
Fax Number	:	718-752-1837

Provider Business Practice Location Address
First Line	:	1555 3RD AVE
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10128-3107
Country	:	US
Telephone Number	:	212-870-9497
Fax Number	:	212-870-9335

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

Provider Enumeration Date	:	08/20/2006
Last Update Date	:	02/15/2013

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