Provider Demographics
NPI:1164127098
Name:JASWAL, SANDEEP (MD)
Entity Type:Individual
Prefix:MR
First Name:SANDEEP
Middle Name:
Last Name:JASWAL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24 MOORE PARK AVENUE
Mailing Address - Street 2:
Mailing Address - City:NORTH YORK
Mailing Address - State:ONTARIO
Mailing Address - Zip Code:M2M1M9
Mailing Address - Country:CA
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:7600 RIVER RD
Practice Address - Street 2:
Practice Address - City:NORTH BERGEN
Practice Address - State:NJ
Practice Address - Zip Code:07047
Practice Address - Country:US
Practice Address - Phone:201-710-2756
Practice Address - Fax:201-758-2740
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-31
Last Update Date:2023-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program