Basic Information
Provider Information
NPI: 1548989437
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SAHNI
FirstName: JYOTAN
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
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OtherLastName:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 150 EILEEN WAY UNIT 1
Address2:  
City: SYOSSET
State: NY
PostalCode: 117915313
CountryCode: US
TelephoneNumber: 5168555255
FaxNumber:  
Practice Location
Address1: 110 OREGON RD
Address2:  
City: CORTLANDT MANOR
State: NY
PostalCode: 105671232
CountryCode: US
TelephoneNumber: 9147398150
FaxNumber:  
Other Information
ProviderEnumerationDate: 08/24/2022
LastUpdateDate: 08/24/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 08/24/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
208D00000XP116663NYY Allopathic & Osteopathic PhysiciansGeneral Practice 

No ID Information.


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