Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RC0000X | Internist - Cardiovascular Disease | 290394 | NY |
N | 207RC0000X | Internist - Cardiovascular Disease | T2013-070 | AR |
NPI | 1003095654 |
---|---|
Provider Name | Dr. Satish Kenchaiah |
First Address | New York, NY 10029-6504 |
Second Address | New York, NY 10029-6504 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/10/2007 |
Last Update Date | 17/03/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
110086096A | (05) | MA |