Provider Demographics
NPI:1992038251
Name:THAKAR, KEYUR BHARAT (MD)
Entity Type:Individual
Prefix:
First Name:KEYUR
Middle Name:BHARAT
Last Name:THAKAR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:777 N BROADWAY STE 207
Mailing Address - Street 2:
Mailing Address - City:SLEEPY HOLLOW
Mailing Address - State:NY
Mailing Address - Zip Code:10591-1019
Mailing Address - Country:US
Mailing Address - Phone:914-366-1625
Mailing Address - Fax:
Practice Address - Street 1:777 N BROADWAY STE 207
Practice Address - Street 2:
Practice Address - City:SLEEPY HOLLOW
Practice Address - State:NY
Practice Address - Zip Code:10591-1019
Practice Address - Country:US
Practice Address - Phone:914-366-1625
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-09-17
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY279360207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY04176601Medicaid
PA413015N82Medicare PIN
NYJ400223241Medicare PIN