Provider Demographics
NPI:1518062967
Name:KATHIRITHAMBY, KATHRITHAMBY SELLAMUTTU (MD)
Entity Type:Individual
Prefix:DR
First Name:KATHRITHAMBY
Middle Name:SELLAMUTTU
Last Name:KATHIRITHAMBY
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 1:301 EAST 17TH ST.
Mailing Address - Street 2:FLOOR C2/RM. 222
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10003
Mailing Address - Country:US
Mailing Address - Phone:212-263-5072
Mailing Address - Fax:212-263-7254
Practice Address - Street 1:301 EAST 17TH ST.
Practice Address - Street 2:FLOOR C2/RM. 222
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10003
Practice Address - Country:US
Practice Address - Phone:212-263-5072
Practice Address - Fax:212-263-7254
Is Sole Proprietor?:No
Enumeration Date:2006-09-13
Last Update Date:2016-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY128361174400000X
NY128361-1207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00342594Medicaid
NYA400022978Medicare PIN