Individual
DR. SANJEEV V KOTHARE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2001 MARCUS AVE STE W290, NEW HYDE PARK, NY 11042-1098
(516) 465-5255
Mailing address
2001 MARCUS AVE STE W290, NEW HYDE PARK, NY 11042-1098
(516) 465-5255
Taxonomy
Speciality
Code
Description
License number
State
2084N0402X
Neurology with Special Qualifications in Child Neurology Physician
Primary
268754
NY
2084N0600X
Clinical Neurophysiology Physician
268754
NY
2084S0012X
Sleep Medicine (Psychiatry & Neurology) Physician
268754
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03749108
—
NY
Enumeration date
05/24/2006
Last updated
10/02/2017
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