Provider Demographics
NPI:1760424865
Name:SANJAY S KIRTANE MD PC
Entity Type:Organization
Organization Name:SANJAY S KIRTANE MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SANJAY
Authorized Official - Middle Name:
Authorized Official - Last Name:KIRTANE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:516-697-7406
Mailing Address - Street 1:10 CAUSEWAY
Mailing Address - Street 2:
Mailing Address - City:LAWRENCE
Mailing Address - State:NY
Mailing Address - Zip Code:11559-1514
Mailing Address - Country:US
Mailing Address - Phone:516-697-7406
Mailing Address - Fax:
Practice Address - Street 1:10 CAUSEWAY
Practice Address - Street 2:
Practice Address - City:LAWRENCE
Practice Address - State:NY
Practice Address - Zip Code:11559-1514
Practice Address - Country:US
Practice Address - Phone:516-697-7406
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYW16121Medicare ID - Type Unspecified