Provider Demographics
NPI:1922257773
Name:PAJVANI, UTPAL BHAGIRATH (MD, PHD)
Entity Type:Individual
Prefix:DR
First Name:UTPAL
Middle Name:BHAGIRATH
Last Name:PAJVANI
Suffix:
Gender:M
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:1150 SAINT NICHOLAS AVE
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10032-3822
Mailing Address - Country:US
Mailing Address - Phone:212-851-5494
Mailing Address - Fax:212-851-5493
Practice Address - Street 1:1150 SAINT NICHOLAS AVE
Practice Address - Street 2:2ND FLOOR
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10032
Practice Address - Country:US
Practice Address - Phone:212-851-5494
Practice Address - Fax:212-851-5493
Is Sole Proprietor?:No
Enumeration Date:2008-09-17
Last Update Date:2018-08-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY242824-1207RE0101X, 174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYA400045828OtherMEDICARE ID
NY03349584Medicaid