Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RC0000X | Internist - Cardiovascular Disease | 207886 | NY |
Y | 207RI0011X | Interventional Cardiology | 207886 | NY |
NPI | 1013974617 |
---|---|
Provider Name | Sriram S Iyer |
First Address | New York, NY 10021-3513 |
Second Address | New York, NY 10021-3513 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/04/2006 |
Last Update Date | 26/12/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01782609 | (05) | NY |
E83539 | (02) | NY |