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NPI Code Detail

MEDICARE: DR. UMA GAVARASANA M.D.

MEDICARE: DR. UMA GAVARASANA 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
1207R00000XInternal Medicine Physician220424NY

General Provider Information

NPI Number : 1215119896
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. UMA GAVARASANA M.D.
Provider Business Mailing Address
First Line : 915 HILLSIDE AVE
Second Line :
City : NEW HYDE PARK
State : NY
Zip : 11040-2529
Country : US
Telephone Number : 516-437-9660
Fax Number : 516-328-9355
Provider Business Practice Location Address
First Line : 915 HILLSIDE AVE
Second Line :
City : NEW HYDE PARK
State : NY
Zip : 11040-2529
Country : US
Telephone Number : 516-437-9660
Fax Number : 516-328-9355
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/05/2007
Last Update Date : 12/05/2007

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