Basic Information
| Provider Information | |||||||||
| NPI: | 1093905804 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | PAWAR | ||||||||
| FirstName: | NEHA | ||||||||
| MiddleName: | S | ||||||||
| NamePrefix: | |||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | SAWE | ||||||||
| OtherFirstName: | NEHA | ||||||||
| OtherMiddleName: | SUDHEER | ||||||||
| OtherNamePrefix: | |||||||||
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| OtherCredential: | M.D. | ||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 45 RESEARCH WAY | ||||||||
| Address2: | SUITE 105 | ||||||||
| City: | EAST SETAUKET | ||||||||
| State: | NY | ||||||||
| PostalCode: | 117336401 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6316752125 | ||||||||
| FaxNumber: | 6316752624 | ||||||||
| Practice Location | |||||||||
| Address1: | 5036 JERICHO TPKE | ||||||||
| Address2: | SUITE 207 | ||||||||
| City: | COMMACK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 117252812 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6314868372 | ||||||||
| FaxNumber: | 6314868374 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/27/2007 | ||||||||
| LastUpdateDate: | 06/16/2016 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 245361 | NY | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.