Provider Demographics
NPI:1871651950
Name:KIM & SUTARIA MD PC
Entity Type:Organization
Organization Name:KIM & SUTARIA MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BHAGWANDAS
Authorized Official - Middle Name:L
Authorized Official - Last Name:SUTARIA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:716-664-5712
Mailing Address - Street 1:320 PRATHER AVENUE
Mailing Address - Street 2:
Mailing Address - City:JAMESTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:14701-6820
Mailing Address - Country:US
Mailing Address - Phone:716-664-5712
Mailing Address - Fax:716-664-4111
Practice Address - Street 1:320 PRATHER AVENUE
Practice Address - Street 2:
Practice Address - City:JAMESTOWN
Practice Address - State:NY
Practice Address - Zip Code:14701-6820
Practice Address - Country:US
Practice Address - Phone:716-664-5712
Practice Address - Fax:716-664-4111
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-04
Last Update Date:2007-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Multi-Specialty