MEDICARE: DR. SATBACHAN SINGH DHANJAL 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	207R00000X	Internal Medicine Physician	135215	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	135215	OTHER	NY	STATE LICENSE
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1760433031
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SATBACHAN SINGH DHANJAL MD

Provider Business Mailing Address
First Line	:	20707 HILLSIDE AVE
Second Line	:
City	:	QUEENS VILLAGE
State	:	NY
Zip	:	11427-1732
Country	:	US
Telephone Number	:	718-464-9727
Fax Number	:	718-464-9735

Provider Business Practice Location Address
First Line	:	20707 HILLSIDE AVE
Second Line	:
City	:	QUEENS VILLAGE
State	:	NY
Zip	:	11427-1732
Country	:	US
Telephone Number	:	718-464-9727
Fax Number	:	718-464-9735

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

Provider Enumeration Date	:	05/12/2006
Last Update Date	:	06/14/2013

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