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General NPI Number Information
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NPI Number | 1184633513
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Entity Type | Organization
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Legal Business Name | RICHMOND CANCER AND BLOOD DISORDERS P.C.
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Dates
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Enumeration Date | 08/05/2006
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Last Update Date | 10/06/2011
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Provider Practice Location Address
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Address Line | 1384 VICTORY BLVD
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City | STATEN ISLAND
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State | NY
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Zip | 10301-3908
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Country | US
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Telephone | 718-273-2277
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Fax | 718-273-3114
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Provider Business Mailing Address
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Address Line | 15 OLD FARMERS LN
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City | STATEN ISLAND
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State | NY
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Zip | 10304-1439
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Country | US
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Telephone | 718-979-2523
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Fax | 718-273-3114
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. SEETHA R MURUKUTLA
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Credential | M.D.
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Telephone | 718-979-2523
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RH0003X
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Taxonomy Name | Hematology & Oncology Physician
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License Number | 151450
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License Number State | NY
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