Provider Demographics
NPI:1396905402
Name:SINMAYANANDAN, PRANAVAN (MD)
Entity type:Individual
Prefix:DR
First Name:PRANAVAN
Middle Name:
Last Name:SINMAYANANDAN
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 1:1711 CUDABACK AVE # 941751
Mailing Address - Street 2:
Mailing Address - City:NIAGARA FALLS
Mailing Address - State:NY
Mailing Address - Zip Code:14303-1709
Mailing Address - Country:US
Mailing Address - Phone:416-540-0234
Mailing Address - Fax:
Practice Address - Street 1:1711 CUDABACK AVE # 941751
Practice Address - Street 2:
Practice Address - City:NIAGARA FALLS
Practice Address - State:NY
Practice Address - Zip Code:14303-1709
Practice Address - Country:US
Practice Address - Phone:416-540-0234
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-11
Last Update Date:2015-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMT#189998207R00000X
CAA#110440207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine