Healthcare Provider Details

I. General information

NPI: 1295740918
Provider Name (Legal Business Name): NARAYANA SUBRAMANY M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/30/2006
Last Update Date: 02/26/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

225 SOUTH ST
RIDGWAY PA
15853-2033
US

IV. Provider business mailing address

761 JOHNSONBURG RD
SAINT MARYS PA
15857-3483
US

V. Phone/Fax

Practice location:
  • Phone: 814-772-2485
  • Fax: 814-772-2702
Mailing address:
  • Phone: 814-781-1188
  • Fax: 814-772-2702

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License NumberMD038768L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: