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General NPI Number Information
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NPI Number | 1114733086
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Entity Type | Organization
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Legal Business Name | ANANDA SEVA MEDICAL PC
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Dates
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Enumeration Date | 12/05/2024
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Last Update Date | 12/05/2024
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Provider Practice Location Address
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Address Line | 2300 CATHERINE ST
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City | CORTLANDT MANOR
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State | NY
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Zip | 10567-7231
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Country | US
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Telephone | 914-245-1866
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 805
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City | JEFFERSON VALLEY
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State | NY
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Zip | 10535-0805
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Country | US
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Telephone | 914-245-1866
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | SUNEETHA PATTISAPU
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Credential | MD
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Telephone | 914-245-1866
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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