Provider Demographics
NPI:1477664134
Name:DAS, SESHADRI (MD,FACP,MRCP,FACE)
Entity Type:Individual
Prefix:
First Name:SESHADRI
Middle Name:
Last Name:DAS
Suffix:
Gender:M
Credentials:MD,FACP,MRCP,FACE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:774 MANOR RD
Mailing Address - Street 2:SUITE 208
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10314-7038
Mailing Address - Country:US
Mailing Address - Phone:718-273-5522
Mailing Address - Fax:718-273-6522
Practice Address - Street 1:774 MANOR RD
Practice Address - Street 2:SUITE 208
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10314-7038
Practice Address - Country:US
Practice Address - Phone:718-273-5522
Practice Address - Fax:718-273-6522
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2022-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY157846207R00000X, 207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY20D281Medicare PIN
C06698Medicare UPIN