Provider Demographics
NPI:1427191618
Name:SARDAR, HENRY (DO)
Entity Type:Individual
Prefix:DR
First Name:HENRY
Middle Name:
Last Name:SARDAR
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2362 E 4TH ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11223-5426
Mailing Address - Country:US
Mailing Address - Phone:732-654-2407
Mailing Address - Fax:347-823-1150
Practice Address - Street 1:171 ELMORA AVE
Practice Address - Street 2:
Practice Address - City:ELIZABETH
Practice Address - State:NJ
Practice Address - Zip Code:07202-1169
Practice Address - Country:US
Practice Address - Phone:732-654-2407
Practice Address - Fax:347-823-1150
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-15
Last Update Date:2018-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY242950208VP0014X, 208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
No208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation