Provider Demographics
NPI:1376730036
Name:DHILLON, SANDEEP KAUR (MD)
Entity Type:Individual
Prefix:DR
First Name:SANDEEP
Middle Name:KAUR
Last Name:DHILLON
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 1:1401 FRANKLIN AVE
Mailing Address - Street 2:
Mailing Address - City:GARDEN CITY
Mailing Address - State:NY
Mailing Address - Zip Code:11530-1613
Mailing Address - Country:US
Mailing Address - Phone:516-877-2626
Mailing Address - Fax:516-877-0945
Practice Address - Street 1:1401 FRANKLIN AVE
Practice Address - Street 2:
Practice Address - City:GARDEN CITY
Practice Address - State:NY
Practice Address - Zip Code:11530-1613
Practice Address - Country:US
Practice Address - Phone:516-877-2626
Practice Address - Fax:516-877-0945
Is Sole Proprietor?:No
Enumeration Date:2007-09-26
Last Update Date:2021-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY246147207RC0000X
NY60 246147207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYA400143040Medicare PIN