Provider Demographics
NPI:1821231176
Name:SRIVATANA, VESH (MD)
Entity Type:Individual
Prefix:
First Name:VESH
Middle Name:
Last Name:SRIVATANA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:505 E 70TH ST
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10021-4872
Mailing Address - Country:US
Mailing Address - Phone:212-746-1578
Mailing Address - Fax:212-745-8483
Practice Address - Street 1:505 E 70TH ST
Practice Address - Street 2:2ND FLOOR
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021-4872
Practice Address - Country:US
Practice Address - Phone:212-746-1578
Practice Address - Fax:212-745-8483
Is Sole Proprietor?:No
Enumeration Date:2009-04-16
Last Update Date:2024-04-10
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY2664321207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03507715Medicaid