Provider Demographics
NPI:1497903165
Name:ARUNAGIRINATHAN, SUBADRA (OD)
Entity type:Individual
Prefix:DR
First Name:SUBADRA
Middle Name:
Last Name:ARUNAGIRINATHAN
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3455 VESTAL PKWY E
Mailing Address - Street 2:
Mailing Address - City:VESTAL
Mailing Address - State:NY
Mailing Address - Zip Code:13850-2147
Mailing Address - Country:US
Mailing Address - Phone:561-308-0013
Mailing Address - Fax:
Practice Address - Street 1:3455 VESTAL PKWY E
Practice Address - Street 2:
Practice Address - City:VESTAL
Practice Address - State:NY
Practice Address - Zip Code:13850-2147
Practice Address - Country:US
Practice Address - Phone:607-722-2020
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-09-05
Last Update Date:2008-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY007359152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist