Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208G00000X | Cardiothoracic Vascular Surgeon | 198753-1 | NY |
NPI | 1154470466 |
---|---|
Provider Name | Dr. Surya Ramachandran Kumar |
First Address | Patchogue, NY 11772-3121 |
Second Address | Patchogue, NY 11772-3121 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 09/01/2007 |
Last Update Date | 18/02/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
02520450 | (05) | NY |
G43349 | (02) | NY |