Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223X0400X | Orthodontists | 038021 | NY |
NPI | 1033248463 |
---|---|
Provider Name | Dr. Ajit Kumar Sardana |
First Address | Blauvelt, NY 10913-2015 |
Second Address | Blauvelt, NY 10913-2015 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/03/2007 |
Last Update Date | 10/04/2018 |