Provider Demographics
NPI:1215673199
Name:SUGANDHA, SWATI
Entity type:Individual
Prefix:
First Name:SWATI
Middle Name:
Last Name:SUGANDHA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:APT-6H, 10 LANDING LANE
Mailing Address - Street 2:
Mailing Address - City:NEW BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08901
Mailing Address - Country:US
Mailing Address - Phone:732-543-4949
Mailing Address - Fax:
Practice Address - Street 1:ISMMS NYC HEALTH & HOSPITALS/QUEENS-NY
Practice Address - Street 2:82-68, 164TH ST
Practice Address - City:QUEENS
Practice Address - State:NY
Practice Address - Zip Code:11432
Practice Address - Country:US
Practice Address - Phone:718-883-4037
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-12
Last Update Date:2022-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program