Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204C00000X | Sports Medicine Doctor | 283814 | MA |
NPI | 1285097469 |
---|---|
Provider Name | Shaik Ahmed Sanai |
First Address | Oceanside, NY 11572-1551 |
Second Address | Oceanside, NY 11572-1551 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/04/2016 |
Last Update Date | 27/09/2021 |