Provider Demographics
NPI:1679830822
Name:TANEJA, SANJEEV ROY (MD)
Entity Type:Individual
Prefix:DR
First Name:SANJEEV
Middle Name:ROY
Last Name:TANEJA
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 1:35 W 110TH ST
Mailing Address - Street 2:APT 2J
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10026-4314
Mailing Address - Country:US
Mailing Address - Phone:917-464-3780
Mailing Address - Fax:
Practice Address - Street 1:35 W 110TH ST
Practice Address - Street 2:APT 2J
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10026-4314
Practice Address - Country:US
Practice Address - Phone:917-464-3780
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-04-12
Last Update Date:2012-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0039012084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology