Provider Demographics
NPI:1649244476
Name:SANDHU, NIHAL S (MD)
Entity Type:Individual
Prefix:
First Name:NIHAL
Middle Name:S
Last Name:SANDHU
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 1:55 OLD TURNPIKE RD
Mailing Address - Street 2:SUITE 607
Mailing Address - City:NANUET
Mailing Address - State:NY
Mailing Address - Zip Code:10954-2461
Mailing Address - Country:US
Mailing Address - Phone:845-623-6661
Mailing Address - Fax:845-623-6698
Practice Address - Street 1:55 OLD TURNPIKE RD
Practice Address - Street 2:SUITE 607
Practice Address - City:NANUET
Practice Address - State:NY
Practice Address - Zip Code:10954-2461
Practice Address - Country:US
Practice Address - Phone:845-623-6661
Practice Address - Fax:845-623-6698
Is Sole Proprietor?:No
Enumeration Date:2006-02-16
Last Update Date:2014-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY151247207R00000X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00805876Medicaid
NY090591Medicare ID - Type Unspecified
C05327Medicare UPIN