Provider Demographics
NPI:1518268341
Name:SUNDARAM, LAKSHMAN (MD, MPH)
Entity type:Individual
Prefix:DR
First Name:LAKSHMAN
Middle Name:
Last Name:SUNDARAM
Suffix:
Gender:M
Credentials:MD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8002 KEW GARDENS RD FL 5
Mailing Address - Street 2:
Mailing Address - City:KEW GARDENS
Mailing Address - State:NY
Mailing Address - Zip Code:11415-3600
Mailing Address - Country:US
Mailing Address - Phone:347-453-5682
Mailing Address - Fax:
Practice Address - Street 1:515 W 59TH ST
Practice Address - Street 2:APT 24 P
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10019-1047
Practice Address - Country:US
Practice Address - Phone:917-349-2065
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-11-10
Last Update Date:2025-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY332070208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine