Provider Demographics
NPI:1285875724
Name:MITHANI, SIMA (MD)
Entity type:Individual
Prefix:DR
First Name:SIMA
Middle Name:
Last Name:MITHANI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:SIMA
Other - Middle Name:
Other - Last Name:KOTHARI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:660 WHITE PLAINS RD FL 4
Mailing Address - Street 2:
Mailing Address - City:TARRYTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:10591-5139
Mailing Address - Country:US
Mailing Address - Phone:914-984-2546
Mailing Address - Fax:
Practice Address - Street 1:1 CROSFIELD AVE STE 201
Practice Address - Street 2:
Practice Address - City:WEST NYACK
Practice Address - State:NY
Practice Address - Zip Code:10994-2229
Practice Address - Country:US
Practice Address - Phone:845-727-1370
Practice Address - Fax:845-727-1377
Is Sole Proprietor?:No
Enumeration Date:2009-03-12
Last Update Date:2024-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA08949500207K00000X
NY252180207R00000X, 207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine