Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2081P2900X | Pain Medicine | 238259 | NY |
NPI | 1265622435 |
---|---|
Provider Name | Dr. Vijay Srichand Sidhwani |
First Address | New Hyde Park, NY 11040-1902 |
Second Address | Oceanside, NY 11572-3204 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/07/2007 |
Last Update Date | 09/10/2012 |