Provider Demographics
NPI:1245336619
Name:CHOLKAR-BAKARE, SANJIVANI (MBBS; FACS)
Entity type:Individual
Prefix:DR
First Name:SANJIVANI
Middle Name:
Last Name:CHOLKAR-BAKARE
Suffix:
Gender:F
Credentials:MBBS; FACS
Other - Prefix:DR
Other - First Name:SANJIVANI
Other - Middle Name:C
Other - Last Name:BAKARE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MBBS, FACS
Mailing Address - Street 1:2 OLD SOMERS RD
Mailing Address - Street 2:
Mailing Address - City:SOMERS
Mailing Address - State:NY
Mailing Address - Zip Code:10589-2921
Mailing Address - Country:US
Mailing Address - Phone:718-584-9000
Mailing Address - Fax:718-741-4621
Practice Address - Street 1:130 W KINGSBRIDGE RD
Practice Address - Street 2:112
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10468-3904
Practice Address - Country:US
Practice Address - Phone:718-584-9000
Practice Address - Fax:718-741-4621
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY119961208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery