Provider Demographics
NPI:1417937046
Name:NARASIMHAN, VIDYA
Entity Type:Individual
Prefix:
First Name:VIDYA
Middle Name:
Last Name:NARASIMHAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 556
Mailing Address - Street 2:
Mailing Address - City:MILLWOOD
Mailing Address - State:NY
Mailing Address - Zip Code:10546-0556
Mailing Address - Country:US
Mailing Address - Phone:914-241-0567
Mailing Address - Fax:
Practice Address - Street 1:341 ROUTE 312
Practice Address - Street 2:
Practice Address - City:BREWSTER
Practice Address - State:NY
Practice Address - Zip Code:10509-2328
Practice Address - Country:US
Practice Address - Phone:914-241-0567
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-01-19
Last Update Date:2008-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY198281173000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes173000000XOther Service ProvidersLegal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY037411OtherMVP
NYP406000OtherOXFORD
NY0D3240OtherHEALTHNET
NY01654640Medicaid
NY2041011OtherAETNA
NY1427342OtherUNITED HEALTHCARE
NY95G551OtherBLUE CROSS
NY510528208OtherCIGNA
NY2099739OtherGHI
NY1427342OtherUNITED HEALTHCARE
NY95G551OtherBLUE CROSS