Provider Demographics
NPI:1295835577
Name:KRISHNASAMY, SATHYA (MD)
Entity Type:Individual
Prefix:
First Name:SATHYA
Middle Name:
Last Name:KRISHNASAMY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:501 E BROADWAY
Mailing Address - Street 2:#220
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40202-1785
Mailing Address - Country:US
Mailing Address - Phone:502-589-4856
Mailing Address - Fax:502-589-5093
Practice Address - Street 1:201 ABRAHAM FLEXNER WAY
Practice Address - Street 2:#1001
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40202-3841
Practice Address - Country:US
Practice Address - Phone:502-589-6788
Practice Address - Fax:502-589-5093
Is Sole Proprietor?:No
Enumeration Date:2006-09-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KY35404207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism