Provider Demographics
NPI:1265753768
Name:MATHRANI, ROHINI (ROHINI MATHRANI)
Entity type:Individual
Prefix:DR
First Name:ROHINI
Middle Name:
Last Name:MATHRANI
Suffix:
Gender:F
Credentials:ROHINI MATHRANI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:226 E 85TH ST
Mailing Address - Street 2:APT 5D
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10028-3088
Mailing Address - Country:US
Mailing Address - Phone:847-975-5168
Mailing Address - Fax:
Practice Address - Street 1:3745 75TH ST
Practice Address - Street 2:
Practice Address - City:JACKSON HEIGHTS
Practice Address - State:NY
Practice Address - Zip Code:11372-6435
Practice Address - Country:US
Practice Address - Phone:718-898-0600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-18
Last Update Date:2015-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY050548831223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics