Provider Demographics
NPI:1265452262
Name:NATHAN, SATHIA V (MD)
Entity Type:Individual
Prefix:MR
First Name:SATHIA
Middle Name:V
Last Name:NATHAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:6934 WILLIAMS ROAD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:NIAGARA FALLS
Mailing Address - State:NY
Mailing Address - Zip Code:14304
Mailing Address - Country:US
Mailing Address - Phone:716-297-8260
Mailing Address - Fax:716-297-1360
Practice Address - Street 1:6934 WILLIAMS ROAD
Practice Address - Street 2:SUITE 200
Practice Address - City:NIAGARA FALLS
Practice Address - State:NY
Practice Address - Zip Code:14304
Practice Address - Country:US
Practice Address - Phone:716-297-8260
Practice Address - Fax:716-297-1360
Is Sole Proprietor?:No
Enumeration Date:2006-07-20
Last Update Date:2010-08-11
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY133181173000000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No173000000XOther Service ProvidersLegal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00616055Medicaid
NY006160220Medicaid
NY00616055Medicaid
NY133181Medicare UPIN
NY006160220Medicaid
NY005077631Medicare ID - Type Unspecified