Healthcare Provider Details

I. General information

NPI: 1225544752
Provider Name (Legal Business Name): KATRIYAR MEDICAL, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/20/2017
Last Update Date: 03/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

378 SYOSSET WOODBURY RD
WOODBURY NY
11797-1200
US

IV. Provider business mailing address

6 BELKNAP CT
HUNTINGTON NY
11743-4897
US

V. Phone/Fax

Practice location:
  • Phone: 800-655-2656
  • Fax: 412-822-7411
Mailing address:
  • Phone: 800-655-2656
  • Fax: 412-822-7411

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License Number225694
License Number StateNY

VIII. Authorized Official

Name: NEERAJ KATRIYAR
Title or Position: OWNER
Credential: MD
Phone: 917-318-1542