Provider Demographics
NPI:1003668344
Name:PRADEEP, ARUN GAJAN
Entity Type:Individual
Prefix:DR
First Name:ARUN GAJAN
Middle Name:
Last Name:PRADEEP
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:204 SAMHITA REGENCY FLAT 1ST MAIN
Mailing Address - Street 2:PAI LAYOUT
Mailing Address - City:BENGALURU
Mailing Address - State:KARNATAKA
Mailing Address - Zip Code:00000
Mailing Address - Country:IN
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:475 SEAVIEW AVE STATEN ISLAND DEPARTMENT OF MEDICINE
Practice Address - Street 2:STATEN ISLAND UNIVERISTY HOSPITAL
Practice Address - City:NEW YORK CITY
Practice Address - State:NY
Practice Address - Zip Code:10305
Practice Address - Country:US
Practice Address - Phone:718-226-9522
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-02
Last Update Date:2024-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program