Provider Demographics
NPI:1194772350
Name:KAKANI, SONALI (MD)
Entity type:Individual
Prefix:
First Name:SONALI
Middle Name:
Last Name:KAKANI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:877 STEWART AVE
Mailing Address - Street 2:SUITE 2
Mailing Address - City:GARDEN CITY
Mailing Address - State:NY
Mailing Address - Zip Code:11530-4803
Mailing Address - Country:US
Mailing Address - Phone:516-222-1105
Mailing Address - Fax:516-222-1161
Practice Address - Street 1:877 STEWART AVE
Practice Address - Street 2:SUITE 2
Practice Address - City:GARDEN CITY
Practice Address - State:NY
Practice Address - Zip Code:11530-4803
Practice Address - Country:US
Practice Address - Phone:516-222-1105
Practice Address - Fax:516-222-1161
Is Sole Proprietor?:No
Enumeration Date:2006-05-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2140022085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
H69958Medicare UPIN
NY569S71Medicare ID - Type UnspecifiedEMPIRE MEDICARE