Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0129X | Vascular Surgeon | 245485 | NY |
NPI | 1033139803 |
---|---|
Provider Name | Dr. Suresh Kumar Nahata |
First Address | Brooklyn, NY 11235-5842 |
Second Address | Far Rockaway, NY 11691-4423 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/07/2006 |
Last Update Date | 09/08/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
02427365 | (05) | NY |
I00367 | (02) | NY |