1114094430 NPI number — SURJEET POHAR MD

Table of content: SURJEET POHAR MD (NPI 1114094430)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1114094430 NPI number — SURJEET POHAR MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
POHAR
Provider First Name:
SURJEET
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1114094430
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/03/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3085 HARLEM RD
Provider Second Line Business Mailing Address:
STE 350
Provider Business Mailing Address City Name:
CHEEKTOWAGA
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
14225-2591
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
716-844-5600
Provider Business Mailing Address Fax Number:
716-844-5750

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
117 FOOTE AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
JAMESTOWN
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
14701-6947
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
716-338-9500
Provider Business Practice Location Address Fax Number:
716-338-9550
Provider Enumeration Date:
11/30/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 2085R0001X , with the licence number:  0101240892 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 2085R0001X , with the licence number: 219430 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 2157601 . This is a "UHC/MAMSI" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 248692 . This is a "ANTHEM 600 GRESHAM DR" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 308588 . This is a "ANTHEM LAKE WRIGHT DR" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: P01233062 . This is a "RAILROAD MEDICARE PIN" identifier , issued by the state of ( IN ) . This identifiers is of the category "OTHER".
  • Identifier: PAR . This is a "FIRST HEALTH COMMERCIAL/SOUTHERN HEALTH/COVENTRY" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: PAR . This is a "CORVEL/CORCARE" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 07269 . This is a "BC/BS" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".
  • Identifier: 10014992 . This is a "SENTARA" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: PAR . This is a "AETNA" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: PAR . This is a "MULTIPLAN" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: PAR . This is a "VIRGINIA HEALTH NETWORK" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 5907269 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".
  • Identifier: PAR . This is a "USA MANAGED CARE" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: PAR . This is a "CIGNA" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: PAR . This is a "TRICARE/CHAMPUS" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: PAR . This is a "VIRGINIA PREMIER HEALTH" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 1114094430 , issued by the state of ( VA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 201148980 , issued by the state of ( IN ) . This identifiers is of the category "MEDICAID".




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