Provider Demographics
NPI:1487693255
Name:SANGHAVI, MAYA MANSUKHLAL (MD;FACOG)
Entity type:Individual
Prefix:DR
First Name:MAYA
Middle Name:MANSUKHLAL
Last Name:SANGHAVI
Suffix:
Gender:F
Credentials:MD;FACOG
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 22581
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10087-2581
Mailing Address - Country:US
Mailing Address - Phone:856-669-6050
Mailing Address - Fax:856-528-3117
Practice Address - Street 1:27 MOUNTAIN BLVD STE 6
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:NJ
Practice Address - Zip Code:07059-5605
Practice Address - Country:US
Practice Address - Phone:973-736-1100
Practice Address - Fax:973-736-1134
Is Sole Proprietor?:No
Enumeration Date:2006-06-06
Last Update Date:2021-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA02928100207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJSA434465Medicare ID - Type Unspecified
NJD06367Medicare UPIN