MEDICARE: MICHELLE ANNE JINDAL 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	208000000X	Pediatrics Physician	226404	NY

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	:	1598766974
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHELLE ANNE JINDAL MD

Provider Business Mailing Address
First Line	:	780 E TREMONT AVE
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10460-4101
Country	:	US
Telephone Number	:	718-583-3506
Fax Number	:	718-583-3506

Provider Business Practice Location Address
First Line	:	984 N BROADWAY STE 405
Second Line	:
City	:	YONKERS
State	:	NY
Zip	:	10701-1308
Country	:	US
Telephone Number	:	914-965-2101
Fax Number	:	914-965-2102

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

Provider Enumeration Date	:	08/09/2005
Last Update Date	:	02/02/2022

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