Provider Demographics
NPI:1720614654
Name:MATTANCHERIL, SUNANDA SAIRAM (MD)
Entity type:Individual
Prefix:DR
First Name:SUNANDA
Middle Name:SAIRAM
Last Name:MATTANCHERIL
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:1 ATWELL RD
Mailing Address - Street 2:
Mailing Address - City:COOPERSTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:13326-1301
Mailing Address - Country:US
Mailing Address - Phone:607-547-3500
Mailing Address - Fax:
Practice Address - Street 1:1 ATWELL RD
Practice Address - Street 2:
Practice Address - City:COOPERSTOWN
Practice Address - State:NY
Practice Address - Zip Code:13326-1301
Practice Address - Country:US
Practice Address - Phone:607-547-3500
Practice Address - Fax:304-293-8724
Is Sole Proprietor?:No
Enumeration Date:2020-03-23
Last Update Date:2024-09-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY329912-012084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry