Provider Demographics
NPI:1346243565
Name:BABU, SATEESH (MD)
Entity type:Individual
Prefix:DR
First Name:SATEESH
Middle Name:
Last Name:BABU
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:PO BOX 9
Mailing Address - Street 2:
Mailing Address - City:HAWTHORNE
Mailing Address - State:NY
Mailing Address - Zip Code:10532-0009
Mailing Address - Country:US
Mailing Address - Phone:914-593-7880
Mailing Address - Fax:914-593-7881
Practice Address - Street 1:103 S BEDFORD RD
Practice Address - Street 2:SUITE 207
Practice Address - City:MOUNT KISCO
Practice Address - State:NY
Practice Address - Zip Code:10549-3440
Practice Address - Country:US
Practice Address - Phone:914-241-3204
Practice Address - Fax:914-593-7881
Is Sole Proprietor?:Yes
Enumeration Date:2005-05-23
Last Update Date:2021-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1173052086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY38A3833641OtherMEDICARE PTAN
NYA400027966OtherMEDICARE PTAN
NY00670842Medicaid
NYA100027964OtherMEDICARE PTAN
NY770002079OtherRAIL ROAD MEDICARE
NY38A3835223OtherMEDICARE PTAN
NY38A383K222OtherMEDICARE PTAN
NY38A383K221OtherMEDICARE PTAN
NY38A3835223OtherMEDICARE PTAN
NY00670842Medicaid