| Organization Name: | SATBACHAN DHANJAL |
| NPI Number: | 1013356815 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | SATBACHAN S DHANJAL (OWNER) |
| Mailing Address: | 20707 Hillside Ave Queens Village |
| State: | NY US |
| Postal Code: | 114271732 |
| Phone Number: | 7184649727 |
| Fax Number: | 7184649735 |
| NPI Enumeration Date: | 06/14/2013 |
| NPI Last Update Date: | 06/14/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QP2300X |
| License Number: | 135215 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Primary Care |
| Taxonomy Definition: | |