Basic Information
Provider Information
NPI: 1194987230
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: IYENGAR
FirstName: NEIL
MiddleName: MUKUND
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1275 YORK AVE
Address2:  
City: NEW YORK
State: NY
PostalCode: 100656007
CountryCode: US
TelephoneNumber: 2126392000
FaxNumber:  
Practice Location
Address1: 1275 YORK AVE
Address2:  
City: NEW YORK
State: NY
PostalCode: 100656007
CountryCode: US
TelephoneNumber: 2126392000
FaxNumber:  
Other Information
ProviderEnumerationDate: 06/30/2008
LastUpdateDate: 08/07/2014
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207R00000X125054742ILN Allopathic & Osteopathic PhysiciansInternal Medicine 
207RH0003X260648-1NYY Allopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
207RX0202X260648NYN Allopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology

No ID Information.


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