Provider Demographics
NPI:1467137034
Name:AZHAGAPPA, SUBASHINI
Entity Type:Individual
Prefix:
First Name:SUBASHINI
Middle Name:
Last Name:AZHAGAPPA
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:SUNY DOWNSTATE MEDICAL CENTRE, BOX 49
Mailing Address - Street 2:450 CLARKSON AVENUE
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11203
Mailing Address - Country:US
Mailing Address - Phone:718-270-2078
Mailing Address - Fax:
Practice Address - Street 1:SUNY DOWNSTATE MEDICAL CENTRE,
Practice Address - Street 2:450 CLARKSON AVENUE
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11203
Practice Address - Country:US
Practice Address - Phone:718-270-2078
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-20
Last Update Date:2023-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program