Healthcare Provider Details

I. General information

NPI: 1417937046
Provider Name (Legal Business Name): VIDYA NARASIMHAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/19/2006
Last Update Date: 06/05/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

341 ROUTE 312
BREWSTER NY
10509-2328
US

IV. Provider business mailing address

PO BOX 556
MILLWOOD NY
10546-0556
US

V. Phone/Fax

Practice location:
  • Phone: 914-241-0567
  • Fax:
Mailing address:
  • Phone: 914-241-0567
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code173000000X
TaxonomyLegal Medicine
License Number198281
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: