Basic Information
| Provider Information | |||||||||
| NPI: | 1114094430 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | POHAR | ||||||||
| FirstName: | SURJEET | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3085 HARLEM RD | ||||||||
| Address2: | STE 350 | ||||||||
| City: | CHEEKTOWAGA | ||||||||
| State: | NY | ||||||||
| PostalCode: | 142252591 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7168445600 | ||||||||
| FaxNumber: | 7168445750 | ||||||||
| Practice Location | |||||||||
| Address1: | 117 FOOTE AVE | ||||||||
| Address2: | |||||||||
| City: | JAMESTOWN | ||||||||
| State: | NY | ||||||||
| PostalCode: | 147016947 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7163389500 | ||||||||
| FaxNumber: | 7163389550 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/30/2006 | ||||||||
| LastUpdateDate: | 08/03/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 08/03/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2085R0001X | 0101240892 | VA | N | Allopathic & Osteopathic Physicians | Radiology | Radiation Oncology | 2085R0001X | 219430 | NY | Y | Allopathic & Osteopathic Physicians | Radiology | Radiation Oncology |
ID Information
| ID | Type | State | Issuer | Description | 2157601 | 01 | VA | UHC/MAMSI | OTHER | 248692 | 01 | VA | ANTHEM 600 GRESHAM DR | OTHER | 308588 | 01 | VA | ANTHEM LAKE WRIGHT DR | OTHER | P01233062 | 01 | IN | RAILROAD MEDICARE PIN | OTHER | PAR | 01 | VA | FIRST HEALTH COMMERCIAL/SOUTHERN HEALTH/COVENTRY | OTHER | PAR | 01 | VA | CORVEL/CORCARE | OTHER | 07269 | 01 | NC | BC/BS | OTHER | 10014992 | 01 | VA | SENTARA | OTHER | PAR | 01 | VA | AETNA | OTHER | PAR | 01 | VA | MULTIPLAN | OTHER | PAR | 01 | VA | VIRGINIA HEALTH NETWORK | OTHER | 5907269 | 05 | NC | MEDICAID | PAR | 01 | VA | USA MANAGED CARE | OTHER | PAR | 01 | VA | CIGNA | OTHER | PAR | 01 | VA | TRICARE/CHAMPUS | OTHER | PAR | 01 | VA | VIRGINIA PREMIER HEALTH | OTHER | 1114094430 | 05 | VA | MEDICAID | 201148980 | 05 | IN | MEDICAID |