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NPI Code Detail

MEDICARE: ANJALI THANNIKAL

MEDICARE: ANJALI THANNIKAL
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
1390200000XStudent in an Organized Health Care Education/Training ProgramNY

General Provider Information

NPI Number : 1417805565
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANJALI THANNIKAL
Provider Business Mailing Address
First Line : 24 HIGHCLERE LN
Second Line :
City : VALHALLA
State : NY
Zip : 10595-1318
Country : US
Telephone Number : 914-400-7816
Fax Number :
Provider Business Practice Location Address
First Line : 4422 3RD AVE
Second Line :
City : BRONX
State : NY
Zip : 10457-2545
Country : US
Telephone Number : 718-960-9000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/16/2026
Last Update Date : 03/16/2026

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Directions to “ ANJALI THANNIKAL ” Practice Location

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