Provider Demographics
NPI:1154610830
Name:SAWALE, KUNAL BHALCHANDRA (MD)
Entity type:Individual
Prefix:DR
First Name:KUNAL
Middle Name:BHALCHANDRA
Last Name:SAWALE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:50 PRESIDENTIAL PLZ
Mailing Address - Street 2:APT 601
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13202-2229
Mailing Address - Country:US
Mailing Address - Phone:315-395-0106
Mailing Address - Fax:315-464-7564
Practice Address - Street 1:750 E ADAMS ST
Practice Address - Street 2:SUNY UPSTATE MEDICAL UNIVERSITY
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13210-2342
Practice Address - Country:US
Practice Address - Phone:315-464-5800
Practice Address - Fax:315-464-7564
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-01
Last Update Date:2011-04-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NYASO552489172208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics