Kantharaj, Mary Sujana
Kantharaj, Mary Sujana is an individual health care provider with primary practice located at 15 Riverside Dr , Johnson City NY 13790-2742. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Medical, which is considered as her primary health care specialty. Kantharaj, Mary Sujana can be contacted via phone (607) 770-9050.Contact Information
Primary practice address
15 Riverside Dr
Johnson City NY 13790-2742
Phone: (607) 770-9050
Fax: (607) 770-9091
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Medical | 363AM0700X | 009664 | New York |
Profile Details
| NPI number | 1417947631 |
|---|---|
| LBN Legal business name | Kantharaj, Mary Sujana |
| Credentials | RPA-C |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 27th, 2005 |
| Last updated | Jul 9th, 2007 - about 18 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1417947631 | NPPES |
| New York | MEDICAID | 01283132 |
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