Provider Demographics
NPI:1770673212
Name:SARWAL, MOHAN LAL (MD)
Entity Type:Individual
Prefix:DR
First Name:MOHAN
Middle Name:LAL
Last Name:SARWAL
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 1:2768 GENEVIEVE CT
Mailing Address - Street 2:
Mailing Address - City:NORTH BELLMORE
Mailing Address - State:NY
Mailing Address - Zip Code:11710-2004
Mailing Address - Country:US
Mailing Address - Phone:516-826-7405
Mailing Address - Fax:
Practice Address - Street 1:3289 46TH ST
Practice Address - Street 2:
Practice Address - City:LONG ISLAND CITY
Practice Address - State:NY
Practice Address - Zip Code:11103-1911
Practice Address - Country:US
Practice Address - Phone:718-472-9641
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY133309208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00529204Medicaid
NY33713Medicare ID - Type Unspecified
NYB88480Medicare UPIN