Provider Demographics
NPI:1043585318
Name:BAIDWAN, SANJEET KAUR (MD)
Entity Type:Individual
Prefix:DR
First Name:SANJEET
Middle Name:KAUR
Last Name:BAIDWAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:529 ATLANTIC AVE APT B
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11217-4903
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:529 ATLANTIC AVE APT B
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11217-4903
Practice Address - Country:US
Practice Address - Phone:806-535-4809
Practice Address - Fax:806-535-4809
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-20
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT1.054456207R00000X
390200000X
NY284079207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program