MEDICARE: SANJAY S KIRTANE MD PC

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

General Provider Information

NPI Number	:	1760424865
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SANJAY S KIRTANE MD PC

Provider Business Mailing Address
First Line	:	10 CAUSEWAY
Second Line	:
City	:	LAWRENCE
State	:	NY
Zip	:	11559-1514
Country	:	US
Telephone Number	:	516-697-7406
Fax Number	:

Provider Business Practice Location Address
First Line	:	10 CAUSEWAY
Second Line	:
City	:	LAWRENCE
State	:	NY
Zip	:	11559-1514
Country	:	US
Telephone Number	:	516-697-7406
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	SANJAY KIRTANE
Credential	:	MD
Telephone Number	:	516-697-7406

Provider Enumeration Date	:	06/12/2006
Last Update Date	:	08/22/2020

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