Basic Information
Provider Information
NPI: 1659536829
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: MAKHIJANI
FirstName: SUMEET
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 725
Address2:  
City: COOPERSTOWN
State: NY
PostalCode: 133260725
CountryCode: US
TelephoneNumber: 6075473080
FaxNumber: 6075476553
Practice Location
Address1: 1 ATWELL RD
Address2:  
City: COOPERSTOWN
State: NY
PostalCode: 133261301
CountryCode: US
TelephoneNumber: 6075473080
FaxNumber: 6075476553
Other Information
ProviderEnumerationDate: 07/27/2008
LastUpdateDate: 08/02/2011
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2086S0122X260796NYY Allopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive Surgery

No ID Information.


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