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General NPI Number Information
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NPI Number | 1649520685
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Entity Type | Organization
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Legal Business Name | SAVERIMUTTU MEDICAL PC
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Dates
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Enumeration Date | 09/18/2012
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Last Update Date | 09/18/2012
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Provider Practice Location Address
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Address Line | 2435 VICTORY BLVD
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City | STATEN ISLAND
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State | NY
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Zip | 10314-6633
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Country | US
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Telephone | 646-275-4334
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Fax |
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Provider Business Mailing Address
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Address Line | 398 GOWER ST STATEN ISLAND
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City | STATEN ISLAND
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State | NY
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Zip | 10314-5333
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Country | US
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Telephone | 646-275-4334
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Fax |
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Authorized Official
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Title or Position | MANAGING DIRECTOR
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Name | DR. JESSIE K SAVERIMUTTU
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Credential | M.D
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Telephone | 646-417-0747
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RI0200X
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Taxonomy Name | Infectious Disease Physician
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License Number |
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License Number State |
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