Provider Demographics
NPI:1003054990
Name:S. NADESAN PHYSICIAN, LLC
Entity Type:Organization
Organization Name:S. NADESAN PHYSICIAN, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL BILLER
Authorized Official - Prefix:
Authorized Official - First Name:URMI
Authorized Official - Middle Name:A
Authorized Official - Last Name:PARIKH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-322-3454
Mailing Address - Street 1:308A EAST 15TH STREET
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10003
Mailing Address - Country:US
Mailing Address - Phone:212-420-6460
Mailing Address - Fax:646-602-1091
Practice Address - Street 1:308A EAST 15TH STREET
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10003
Practice Address - Country:US
Practice Address - Phone:212-420-6460
Practice Address - Fax:646-602-1091
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-30
Last Update Date:2009-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYWEW681Medicare PIN