Provider Demographics
NPI:1609496124
Name:DOKO MEDICAL INC.
Entity Type:Organization
Organization Name:DOKO MEDICAL INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:VANOTHACHADRAN
Authorized Official - Middle Name:
Authorized Official - Last Name:SHANMUGARAJAH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:647-992-7248
Mailing Address - Street 1:3815 PUTNAM AVE W APT 5K
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10463-2477
Mailing Address - Country:US
Mailing Address - Phone:647-992-7284
Mailing Address - Fax:
Practice Address - Street 1:3815 PUTNAM AVE W APT 5K
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10463-2477
Practice Address - Country:US
Practice Address - Phone:647-992-7284
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-24
Last Update Date:2024-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty