Provider Demographics
NPI:1740257203
Name:ACHARYA, SATISH (MD)
Entity type:Individual
Prefix:
First Name:SATISH
Middle Name:
Last Name:ACHARYA
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 1:1200 JEFFERSON RD
Mailing Address - Street 2:SUITE 310
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14623-3158
Mailing Address - Country:US
Mailing Address - Phone:585-730-4872
Mailing Address - Fax:585-730-4285
Practice Address - Street 1:1200 JEFFERSON RD
Practice Address - Street 2:SUITE 310
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14623-3158
Practice Address - Country:US
Practice Address - Phone:585-730-4872
Practice Address - Fax:585-730-4285
Is Sole Proprietor?:No
Enumeration Date:2006-03-03
Last Update Date:2014-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY154870207L00000X, 207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYBA1259Medicare PIN
C49672Medicare UPIN