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General NPI Number Information
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NPI Number | 1467694596
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Entity Type | Individual
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Provider Name | SURY M PUTCHA M.D.
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Gender | Male
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Dates
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Enumeration Date | 04/03/2009
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Last Update Date | 04/03/2009
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Provider Practice Location Address
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Address Line | 201 E MAIN ST
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City | ENDICOTT
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State | NY
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Zip | 13760-4816
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Country | US
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Telephone | 607-785-2050
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Fax | 607-785-2034
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Provider Business Mailing Address
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Address Line | 201 E MAIN ST
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City | ENDICOTT
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State | NY
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Zip | 13760-4816
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Country | US
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Telephone | 607-785-2050
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Fax | 607-785-2034
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207XS0106X
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Taxonomy Name | Orthopaedic Hand Surgery Physician
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License Number | 100032
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License Number State | NY
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