Provider Demographics
NPI:1952834319
Name:DASWANI, CHANDINI (NP)
Entity Type:Individual
Prefix:
First Name:CHANDINI
Middle Name:
Last Name:DASWANI
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:CHANDINI
Other - Middle Name:
Other - Last Name:SANDHU
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:NP
Mailing Address - Street 1:620 WASHINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:PLAINVIEW
Mailing Address - State:NY
Mailing Address - Zip Code:11803-1827
Mailing Address - Country:US
Mailing Address - Phone:516-728-2119
Mailing Address - Fax:
Practice Address - Street 1:130 E 77TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10075-1851
Practice Address - Country:US
Practice Address - Phone:212-434-6428
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-04
Last Update Date:2017-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF341505-1363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily