Provider Demographics
NPI:1649232778
Name:SATHI, SUMEER (MD)
Entity Type:Individual
Prefix:
First Name:SUMEER
Middle Name:
Last Name:SATHI
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 1:100 HOSPITAL RD
Mailing Address - Street 2:SUITE 216
Mailing Address - City:EAST PATCHOGUE
Mailing Address - State:NY
Mailing Address - Zip Code:11772-8809
Mailing Address - Country:US
Mailing Address - Phone:631-475-5511
Mailing Address - Fax:631-475-5544
Practice Address - Street 1:100 HOSPITAL RD
Practice Address - Street 2:SUITE 216
Practice Address - City:EAST PATCHOGUE
Practice Address - State:NY
Practice Address - Zip Code:11772-8809
Practice Address - Country:US
Practice Address - Phone:631-475-5511
Practice Address - Fax:631-475-5544
Is Sole Proprietor?:No
Enumeration Date:2006-04-04
Last Update Date:2020-06-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY203034207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01770194Medicaid
38E281Medicare ID - Type Unspecified
G27068Medicare UPIN