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General NPI Number Information
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NPI Number | 1598932162
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Entity Type | Individual
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Provider Name | SATHISH JAY SUBBAIAH M.D.
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Gender | Male
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Dates
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Enumeration Date | 05/13/2008
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Last Update Date | 08/21/2025
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Provider Practice Location Address
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Address Line | 2112 MIDDLE COUNTRY RD
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City | CENTEREACH
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State | NY
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Zip | 11720-3519
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Country | US
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Telephone | 631-247-7463
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Fax | 631-532-4911
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Provider Business Mailing Address
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Address Line | 2112 MIDDLE COUNTRY RD
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City | CENTEREACH
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State | NY
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Zip | 11720-3519
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Country | US
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Telephone | 631-247-7463
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Fax | 631-532-4911
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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 | 207T00000X
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Taxonomy Name | Neurological Surgery Physician
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License Number | 207T00000X
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 207T00000X
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Taxonomy Name | Neurological Surgery Physician
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License Number | 247982
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License Number State | NY
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