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General NPI Number Information
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NPI Number | 1982630067
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Entity Type | Individual
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Provider Name | SANATH NALLAINATHAN MD
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Gender | Male
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Dates
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Enumeration Date | 06/23/2006
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Last Update Date | 07/09/2007
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Provider Practice Location Address
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Address Line | 2590 MAIN ST
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City | STRATFORD
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State | CT
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Zip | 06615-5838
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Country | US
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Telephone | 203-377-5988
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Fax | 203-380-0531
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Provider Business Mailing Address
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Address Line | CAYER CIRCLE
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City | HUNTINGTON
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State | CT
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Zip | 06484
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Country | US
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Telephone |
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Fax |
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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 | 2084N0402X
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Taxonomy Name | Neurology with Special Qualifications in Child Neurology Physician
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License Number | 019702
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License Number State | CT
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