MEDICARE: ASMITA SATAPATHY M.D

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	47988	TN
2	207R00000X	Internal Medicine Physician	307600	NY

General Provider Information

NPI Number	:	1043452501
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ASMITA SATAPATHY M.D

Provider Business Mailing Address
First Line	:	777 LARKFIELD RD STE 1
Second Line	:
City	:	COMMACK
State	:	NY
Zip	:	11725-3136
Country	:	US
Telephone Number	:	631-635-5100
Fax Number	:

Provider Business Practice Location Address
First Line	:	777 LARKFIELD RD STE 1
Second Line	:
City	:	COMMACK
State	:	NY
Zip	:	11725-3136
Country	:	US
Telephone Number	:	631-635-5100
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/30/2009
Last Update Date	:	10/26/2020

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