National Provider Identifier
Kanwal Ejaz, M.D
Kanwal Ejaz, M.D is listed in the NPPES registry with a primary specialty of Internal Medicine Physician in Ithaca, NY and a listed phone number of (607) 277-2170.
Profile Overview
- NPI
- 1396954178
- Provider Type
- Individual
- Primary Specialty
- Internal Medicine Physician
- Enumeration Date
- May 21, 2007
- Last Updated
- October 01, 2019
Practice Location
- 905 Hanshaw RD Ste C
- Ithaca, NY 14850-1549
Phone: (607) 277-2170
Specialties
- Internal Medicine Physician (207R00000X)
- Internal Medicine Physician (207R00000X)
Full Record
- NPI
- 1396954178
- Entity Type
- Individual
- Last Name
- Ejaz
- First Name
- Kanwal
- Credential
- M.D
- Mailing Street Address
- 905 Hanshaw RD Ste C
- Mailing City
- Ithaca
- Mailing State
- NY
- Mailing ZIP Code
- 14850-1549
- Mailing Country
- US
- Mailing Phone
- (607) 277-2170
- Mailing Fax
- (607) 277-3232
- Practice Street Address
- 905 Hanshaw RD Ste C
- Practice City
- Ithaca
- Practice State
- NY
- Practice ZIP Code
- 14850-1549
- Practice Country
- US
- Practice Phone
- (607) 277-2170
- Practice Fax
- (607) 277-2329
- Enumeration Date
- May 21, 2007
- Last Updated
- October 01, 2019
- Sex
- Female
- Sole Proprietor
- No
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Internal Medicine Physician (207R00000X), Internal Medicine Physician (207R00000X)
- Other Identifiers
- 05378529 (NY)