Healthcare Provider Details

I. General information

NPI: 1346470945
Provider Name (Legal Business Name): SUSMITA NURSINGHA SARANGI M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/17/2009
Last Update Date: 03/23/2022
Certification Date: 03/23/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3800 RESERVOIR RD NW
WASHINGTON DC
20007-2113
US

IV. Provider business mailing address

3800 RESERVOIR RD NW
WASHINGTON DC
20007-2113
US

V. Phone/Fax

Practice location:
  • Phone: 202-444-2224
  • Fax: 202-444-8817
Mailing address:
  • Phone: 202-444-2224
  • Fax: 202-444-8817

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number101256041
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code2080P0207X
TaxonomyPediatric Hematology & Oncology Physician
License NumberMD046789
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: