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General NPI Number Information
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NPI Number | 1548396203
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Entity Type | Organization
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Legal Business Name | NUTAN ANAND, MD, PC
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Dates
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Enumeration Date | 02/26/2007
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Last Update Date | 03/13/2008
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Provider Practice Location Address
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Address Line | 205 OSBORNE AVE
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City | RIVERHEAD
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State | NY
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Zip | 11901-3021
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Country | US
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Telephone | 631-727-6025
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Fax | 631-727-6025
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Provider Business Mailing Address
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Address Line | 100 LAFAYETTE DR
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City | SYOSSET
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State | NY
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Zip | 11791-3934
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Country | US
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Telephone | 516-364-4600
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Fax | 516-364-4690
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MRS. LORIE A DAVIDSON
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Credential |
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Telephone | 516-364-4600
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 51021887
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License Number State | NY
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