Provider Demographics
NPI:1376608208
Name:NARAYANAN, SIVASUBRAMANIAN T (MD)
Entity Type:Individual
Prefix:DR
First Name:SIVASUBRAMANIAN
Middle Name:T
Last Name:NARAYANAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:2165 MATTHEWS AVE
Mailing Address - Street 2:#4J
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10462-2009
Mailing Address - Country:US
Mailing Address - Phone:718-892-9124
Mailing Address - Fax:718-892-4822
Practice Address - Street 1:234 E 149TH ST
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10451-5504
Practice Address - Country:US
Practice Address - Phone:718-579-6010
Practice Address - Fax:718-579-4822
Is Sole Proprietor?:No
Enumeration Date:2006-12-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY001673207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine