Provider Demographics
NPI:1982716726
Name:NAIK, SUWARNA (MD)
Entity Type:Individual
Prefix:
First Name:SUWARNA
Middle Name:
Last Name:NAIK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4156 W MAIN ST RD
Mailing Address - Street 2:
Mailing Address - City:BATAVIA
Mailing Address - State:NY
Mailing Address - Zip Code:14020
Mailing Address - Country:US
Mailing Address - Phone:585-344-0870
Mailing Address - Fax:585-345-1420
Practice Address - Street 1:4156 W MAIN ST RD
Practice Address - Street 2:
Practice Address - City:BATAVIA
Practice Address - State:NY
Practice Address - Zip Code:14020
Practice Address - Country:US
Practice Address - Phone:585-344-0870
Practice Address - Fax:585-345-1420
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2007-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY169002207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00996727Medicaid
NY11509CMedicare PIN
NY00996727Medicaid