Provider Demographics
NPI:1487655692
Name:NATARAJAN, SENTHIL K (MD)
Entity Type:Individual
Prefix:
First Name:SENTHIL
Middle Name:K
Last Name:NATARAJAN
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 1:1870 WINTON RD S
Mailing Address - Street 2:SUITE 1
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14618-3960
Mailing Address - Country:US
Mailing Address - Phone:585-442-4690
Mailing Address - Fax:585-442-4692
Practice Address - Street 1:1870 WINTON RD S
Practice Address - Street 2:SUITE 1
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14618-3960
Practice Address - Country:US
Practice Address - Phone:585-442-4690
Practice Address - Fax:585-442-4692
Is Sole Proprietor?:No
Enumeration Date:2005-08-10
Last Update Date:2010-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY212672207RC0000X, 207RC0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207RC0001XAllopathic & Osteopathic PhysiciansInternal MedicineClinical Cardiac Electrophysiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY7111484OtherAETNA PROVIDER ID
NY2911OtherEXCELLUS BSH PROVIDER ID
NY010212672OtherBLUE CHOICE PROVIDER ID
NY2199567OtherGHI PROVIDER ID
NY02523664Medicaid
NYMDH755OtherPREFERRED CARE PROV ID
NYP00179341OtherRAILROAD MEDICARE PROV ID
NYRA1889Medicare ID - Type UnspecifiedPROVIDER ID
NY2199567OtherGHI PROVIDER ID