Provider Demographics
NPI:1790704948
Name:KHASANI, SINA (MD)
Entity Type:Individual
Prefix:
First Name:SINA
Middle Name:
Last Name:KHASANI
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 1:1208 DEAN ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11216-3101
Mailing Address - Country:US
Mailing Address - Phone:347-909-2453
Mailing Address - Fax:207-947-0344
Practice Address - Street 1:NYU LANGONE LEVIT MEDICAL
Practice Address - Street 2:1220 AVENUE P
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11229
Practice Address - Country:US
Practice Address - Phone:718-759-6065
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-19
Last Update Date:2023-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2598702084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME7151652OtherAETNA
ME048766OtherANTHEM BLUE SHIELD
ME8452220OtherCIGNA
ME431803799Medicaid
MEI33640Medicare UPIN
ME431803799Medicaid