Provider Demographics
NPI:1790945277
Name:PENDHARKAR, SIMA SUHAS (MD)
Entity Type:Individual
Prefix:
First Name:SIMA
Middle Name:SUHAS
Last Name:PENDHARKAR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:177 CONCORD ST
Mailing Address - Street 2:2A
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11201-2021
Mailing Address - Country:US
Mailing Address - Phone:212-523-5918
Mailing Address - Fax:212-523-2842
Practice Address - Street 1:177 CONCORD STREET
Practice Address - Street 2:2A
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11201-4013
Practice Address - Country:US
Practice Address - Phone:919-360-2987
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-10
Last Update Date:2015-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY276425208M00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program