Provider Demographics
NPI:1245455633
Name:JHAVERI, SANDHYA (MD)
Entity type:Individual
Prefix:DR
First Name:SANDHYA
Middle Name:
Last Name:JHAVERI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9525 QUEENS BLVD
Mailing Address - Street 2:SUITE 520
Mailing Address - City:REGO PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11374-4511
Mailing Address - Country:US
Mailing Address - Phone:718-896-4399
Mailing Address - Fax:
Practice Address - Street 1:9525 QUEENS BLVD
Practice Address - Street 2:SUITE 520
Practice Address - City:REGO PARK
Practice Address - State:NY
Practice Address - Zip Code:11374-4511
Practice Address - Country:US
Practice Address - Phone:718-896-4399
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY140470208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY0C0441OtherHEALTHNET
NY0091088OtherGHI
NY481252OtherUNITED HEALTHCARE
NY140470OtherHIP
NY74A951OtherEMPIRE BCBS
NY0568610OtherAETNA HMO
NY0581064OtherCIGNA
NYP3605281OtherOXFORD