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NPI Code Detail

MEDICARE: SATHUU SIVAKUMARAN

MEDICARE: SATHUU SIVAKUMARAN
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
1390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1447086699
Entity Type Code : Individual
Provider Name (Legal Business Name) : SATHUU SIVAKUMARAN
Provider Business Mailing Address
First Line : 4 GILDER ST STE 2
Second Line :
City : LARCHMONT
State : NY
Zip : 10538-2748
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 4 GILDER ST STE 2
Second Line :
City : LARCHMONT
State : NY
Zip : 10538-2748
Country : US
Telephone Number : 838-910-8150
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/12/2024
Last Update Date : 09/12/2024

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Directions to “ SATHUU SIVAKUMARAN ” Practice Location

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