Provider Demographics
NPI:1184008492
Name:PAWASKAR, ADITYA SANJEEV (MD)
Entity type:Individual
Prefix:DR
First Name:ADITYA
Middle Name:SANJEEV
Last Name:PAWASKAR
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 1:33 LEWIS RD
Mailing Address - Street 2:
Mailing Address - City:BINGHAMTON
Mailing Address - State:NY
Mailing Address - Zip Code:13905-1048
Mailing Address - Country:US
Mailing Address - Phone:607-770-0025
Mailing Address - Fax:
Practice Address - Street 1:4433 VESTAL PKWY E
Practice Address - Street 2:
Practice Address - City:VESTAL
Practice Address - State:NY
Practice Address - Zip Code:13850-3556
Practice Address - Country:US
Practice Address - Phone:607-240-2879
Practice Address - Fax:607-240-2972
Is Sole Proprietor?:No
Enumeration Date:2015-07-16
Last Update Date:2020-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY303787207RR0500X
ZZ2013/10/3165208D00000X
CT390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice