Provider Demographics
NPI:1851349716
Name:MAHAJAN, SONALI ROHIT (MD)
Entity Type:Individual
Prefix:
First Name:SONALI
Middle Name:ROHIT
Last Name:MAHAJAN
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 1:225 MILLBURN AVE STE 209A
Mailing Address - Street 2:
Mailing Address - City:MILLBURN
Mailing Address - State:NJ
Mailing Address - Zip Code:07041-1712
Mailing Address - Country:US
Mailing Address - Phone:908-447-8593
Mailing Address - Fax:877-919-0530
Practice Address - Street 1:225 MILLBURN AVE STE 209A
Practice Address - Street 2:
Practice Address - City:MILLBURN
Practice Address - State:NJ
Practice Address - Zip Code:07041-1712
Practice Address - Country:US
Practice Address - Phone:908-447-8593
Practice Address - Fax:877-919-0530
Is Sole Proprietor?:No
Enumeration Date:2006-05-04
Last Update Date:2020-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA107322002084P0804X
GA0545112084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
I32375Medicare UPIN
26BDKBBMedicare ID - Type Unspecified