Provider Demographics
NPI:1164521191
Name:SADHNANI, MANOJ (DPM)
Entity Type:Individual
Prefix:DR
First Name:MANOJ
Middle Name:
Last Name:SADHNANI
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19 HOWARD CT
Mailing Address - Street 2:
Mailing Address - City:PLAINVIEW
Mailing Address - State:NY
Mailing Address - Zip Code:11803-3200
Mailing Address - Country:US
Mailing Address - Phone:718-341-5313
Mailing Address - Fax:718-528-3534
Practice Address - Street 1:23520 147TH AVE
Practice Address - Street 2:
Practice Address - City:ROSEDALE
Practice Address - State:NY
Practice Address - Zip Code:11422-3293
Practice Address - Country:US
Practice Address - Phone:718-341-5313
Practice Address - Fax:718-528-3534
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-22
Last Update Date:2014-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYN005610213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02146647Medicaid
NYU83986Medicare UPIN
NYPE5231Medicare ID - Type Unspecified