Provider Demographics
NPI:1609977545
Name:KANHAI, LUCINDA (PA)
Entity Type:Individual
Prefix:MS
First Name:LUCINDA
Middle Name:
Last Name:KANHAI
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8942 221ST ST
Mailing Address - Street 2:MANAGED CARE D101
Mailing Address - City:QUEENS VILLAGE
Mailing Address - State:NY
Mailing Address - Zip Code:11427-2508
Mailing Address - Country:US
Mailing Address - Phone:718-464-1019
Mailing Address - Fax:718-464-1019
Practice Address - Street 1:8942 221ST ST
Practice Address - Street 2:MANAGED CARE D101
Practice Address - City:QUEENS VILLAGE
Practice Address - State:NY
Practice Address - Zip Code:11427-2508
Practice Address - Country:US
Practice Address - Phone:718-464-1019
Practice Address - Fax:718-464-1019
Is Sole Proprietor?:No
Enumeration Date:2006-09-25
Last Update Date:2011-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY008429363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00246075Medicaid
NY00330231Medicare ID - Type Unspecified