Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0131X | Foot Surgery | 2385 | TX |
NPI | 1275988933 |
---|---|
Provider Name | Sunil Kumar Jeganathan |
First Address | Ontario, NY 14519-9008 |
Second Address | Shenandoah, TX 77380-3250 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/05/2016 |
Last Update Date | 03/08/2020 |