Provider Demographics
NPI:1578133427
Name:MUTHUSAMY KUMARASAMY, VASANTHAN (MBBS)
Entity Type:Individual
Prefix:
First Name:VASANTHAN
Middle Name:
Last Name:MUTHUSAMY KUMARASAMY
Suffix:
Gender:M
Credentials:MBBS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2157 MAIN STREET, SISTER OF CHARITY HOSPITAL
Mailing Address - Street 2:5TH FLOOR, DEPARTMENT OF MEDICINE
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14214
Mailing Address - Country:US
Mailing Address - Phone:716-862-1423
Mailing Address - Fax:716-862-1871
Practice Address - Street 1:2157 MAIN STREET, SISTER OF CHARITY HOSPITAL
Practice Address - Street 2:5TH FLOOR, DEPARTMENT OF MEDICINE
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14214
Practice Address - Country:US
Practice Address - Phone:716-862-1423
Practice Address - Fax:716-862-1871
Is Sole Proprietor?:No
Enumeration Date:2021-07-01
Last Update Date:2022-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program