Provider Demographics
NPI:1922046069
Name:SANGHERA, KANWALWIR (MD)
Entity Type:Individual
Prefix:DR
First Name:KANWALWIR
Middle Name:
Last Name:SANGHERA
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 1:311 NORTH STREET
Mailing Address - Street 2:SUITE 407
Mailing Address - City:WHITE PLAINS
Mailing Address - State:NY
Mailing Address - Zip Code:10605-2217
Mailing Address - Country:US
Mailing Address - Phone:914-287-7617
Mailing Address - Fax:914-287-7618
Practice Address - Street 1:311 NORTH STREET
Practice Address - Street 2:SUITE 407
Practice Address - City:WHITE PLAINS
Practice Address - State:NY
Practice Address - Zip Code:10605-2217
Practice Address - Country:US
Practice Address - Phone:914-287-7617
Practice Address - Fax:914-287-7618
Is Sole Proprietor?:No
Enumeration Date:2006-06-02
Last Update Date:2010-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY184646207RC0000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYG20064Medicare UPIN
NY46J501Medicare PIN