Provider Demographics
NPI:1770980443
Name:AYAN, SAANKRITYA
Entity type:Individual
Prefix:DR
First Name:SAANKRITYA
Middle Name:
Last Name:AYAN
Suffix:
Gender:M
Credentials:
Other - Prefix:DR
Other - First Name:SAANKRITYA
Other - Middle Name:
Other - Last Name:AYAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:3450 WAYNE AVE
Mailing Address - Street 2:APT 25S
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10467-2510
Mailing Address - Country:US
Mailing Address - Phone:917-370-1215
Mailing Address - Fax:
Practice Address - Street 1:111 E 210TH ST
Practice Address - Street 2:HOUSE STAFF OFFICE
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10467-2401
Practice Address - Country:US
Practice Address - Phone:718-920-4806
Practice Address - Fax:718-920-8403
Is Sole Proprietor?:No
Enumeration Date:2014-11-24
Last Update Date:2014-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY90275390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program