Provider Demographics
NPI:1114733086
Name:ANANDA SEVA MEDICAL PC
Entity type:Organization
Organization Name:ANANDA SEVA MEDICAL PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SUNEETHA
Authorized Official - Middle Name:
Authorized Official - Last Name:PATTISAPU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:914-245-1866
Mailing Address - Street 1:PO BOX 805
Mailing Address - Street 2:
Mailing Address - City:JEFFERSON VALLEY
Mailing Address - State:NY
Mailing Address - Zip Code:10535-0805
Mailing Address - Country:US
Mailing Address - Phone:914-245-1866
Mailing Address - Fax:
Practice Address - Street 1:2300 CATHERINE ST
Practice Address - Street 2:
Practice Address - City:CORTLANDT MANOR
Practice Address - State:NY
Practice Address - Zip Code:10567-7231
Practice Address - Country:US
Practice Address - Phone:914-245-1866
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-05
Last Update Date:2024-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty