Provider Demographics
NPI:1427343722
Name:KANAHARA, SATOKO (MD)
Entity type:Individual
Prefix:
First Name:SATOKO
Middle Name:
Last Name:KANAHARA
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:60 MADISON AVE
Mailing Address - Street 2:5TH FLOOR
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10010-1600
Mailing Address - Country:US
Mailing Address - Phone:212-545-2400
Mailing Address - Fax:646-312-0481
Practice Address - Street 1:975 WESTCHESTER AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10459-3204
Practice Address - Country:US
Practice Address - Phone:718-320-4466
Practice Address - Fax:718-991-3829
Is Sole Proprietor?:No
Enumeration Date:2011-06-14
Last Update Date:2025-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT80252207R00000X, 208000000X
NY281649208000000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00695941Medicaid
NY331946Medicare Oscar/Certification
NY331978Medicare Oscar/Certification
NY331945Medicare Oscar/Certification
NY00695941Medicaid
NY331043Medicare Oscar/Certification
NY331943Medicare Oscar/Certification
NY331009Medicare Oscar/Certification
NY331944Medicare Oscar/Certification
NY331952Medicare Oscar/Certification
NYG100000410Medicare Oscar/Certification
NY331058Medicare Oscar/Certification
NY331947Medicare Oscar/Certification
NY331954Medicare Oscar/Certification