Provider Demographics
NPI:1437156593
Name:KANERIA, SUMANLAL JERAMDAS (MD)
Entity Type:Individual
Prefix:DR
First Name:SUMANLAL
Middle Name:JERAMDAS
Last Name:KANERIA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2508 FOXWOOD LN
Mailing Address - Street 2:
Mailing Address - City:VESTAL
Mailing Address - State:NY
Mailing Address - Zip Code:13850-2950
Mailing Address - Country:US
Mailing Address - Phone:607-797-5657
Mailing Address - Fax:
Practice Address - Street 1:20 HAWLEY ST
Practice Address - Street 2:
Practice Address - City:BINGHAMTON
Practice Address - State:NY
Practice Address - Zip Code:13901-3216
Practice Address - Country:US
Practice Address - Phone:607-772-2895
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1301822084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01468455Medicaid
F 05266Medicare UPIN
NY55027BMedicare ID - Type Unspecified