Individual
SHARAD JAITLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
13226 BOOTH MEMORIAL AVE, FLUSHING, NY 11355-5128
(718) 463-5874
Mailing address
13226 BOOTH MEMORIAL AVE, FLUSHING, NY 11355-5128
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
163184
NY
207UN0901X
Nuclear Cardiology Physician
Primary
163184
NY
Other
Enumeration date
11/30/2006
Last updated
12/16/2011
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