Provider Demographics
NPI:1104800762
Name:TRASI, SUNIL S (MD)
Entity type:Individual
Prefix:
First Name:SUNIL
Middle Name:S
Last Name:TRASI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:155 CANAL ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10013-4511
Mailing Address - Country:US
Mailing Address - Phone:212-431-9010
Mailing Address - Fax:212-219-9291
Practice Address - Street 1:155 CANAL ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10013-4511
Practice Address - Country:US
Practice Address - Phone:212-431-9010
Practice Address - Fax:212-219-9291
Is Sole Proprietor?:No
Enumeration Date:2005-12-06
Last Update Date:2008-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY14182312085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00606280Medicaid
NY34A242Medicare ID - Type Unspecified
NY00606280Medicaid