Provider Demographics
NPI:1952839441
Name:SUKUMAR GARGYA, LLC
Entity Type:Organization
Organization Name:SUKUMAR GARGYA, LLC
Other - Org Name:SIGNATURE INTERNAL MEDICINE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SUKUMAR
Authorized Official - Middle Name:
Authorized Official - Last Name:GARGYA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:775-250-2390
Mailing Address - Street 1:2745 SPINNAKER DR
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89519-5759
Mailing Address - Country:US
Mailing Address - Phone:775-250-2390
Mailing Address - Fax:
Practice Address - Street 1:10623 PROFESSIONAL CIR STE A
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89521-5833
Practice Address - Country:US
Practice Address - Phone:775-996-4042
Practice Address - Fax:775-401-6262
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-05-26
Last Update Date:2023-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV11105207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty