MEDICARE: MS. CINDY SHAVANIE BAJNAUTH

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	174400000X	Specialist	2801194	NY

General Provider Information

NPI Number	:	1851129928
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. CINDY SHAVANIE BAJNAUTH

Provider Business Mailing Address
First Line	:	1080 BERGEN ST STE 165
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11216-3340
Country	:	US
Telephone Number	:	718-801-8344
Fax Number	:

Provider Business Practice Location Address
First Line	:	1080 BERGEN ST STE 165
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11216-3340
Country	:	US
Telephone Number	:	718-801-8344
Fax Number	:

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

Provider Enumeration Date	:	07/22/2024
Last Update Date	:	07/22/2024

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