Basic Information
| Provider Information | |||||||||
| NPI: | 1265852446 | ||||||||
| EntityType: | 1 | ||||||||
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| LastName: | NATH | ||||||||
| FirstName: | SARATH | ||||||||
| MiddleName: | G | ||||||||
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| Mailing Information | |||||||||
| Address1: | 450 CLARKSON AVE # 1262 | ||||||||
| Address2: | |||||||||
| City: | BROOKLYN | ||||||||
| State: | NY | ||||||||
| PostalCode: | 112032012 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7182708867 | ||||||||
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| Practice Location | |||||||||
| Address1: | 450 CLARKSON AVE # 1262 | ||||||||
| Address2: | |||||||||
| City: | BROOKLYN | ||||||||
| State: | NY | ||||||||
| PostalCode: | 112032012 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7182708867 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/26/2014 | ||||||||
| LastUpdateDate: | 12/02/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 12/02/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RI0200X | S7735 | TX | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Infectious Disease | 208M00000X | S7735 | TX | N | Allopathic & Osteopathic Physicians | Hospitalist | 390200000X | N | Student, Health Care | Student in an Organized Health Care Education/Training Program | 207R00000X | S7735 | TX | N | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.