Provider Demographics
NPI:1780949974
Name:RANGASAMY, SABARIVINOTH (MD)
Entity type:Individual
Prefix:DR
First Name:SABARIVINOTH
Middle Name:
Last Name:RANGASAMY
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 1:201 WOODHAMPTON DR
Mailing Address - Street 2:
Mailing Address - City:WHITE PLAINS
Mailing Address - State:NY
Mailing Address - Zip Code:10603-1912
Mailing Address - Country:US
Mailing Address - Phone:423-483-9239
Mailing Address - Fax:
Practice Address - Street 1:400 E MAIN ST
Practice Address - Street 2:
Practice Address - City:MOUNT KISCO
Practice Address - State:NY
Practice Address - Zip Code:10549-3417
Practice Address - Country:US
Practice Address - Phone:914-666-1200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-12
Last Update Date:2021-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
NY280246207RA0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RA0001XAllopathic & Osteopathic PhysiciansInternal MedicineAdvanced Heart Failure and Transplant Cardiology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program