Basic Information
Provider Information
NPI: 1861550782
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: PATHMAKUMAR
FirstName: NAVEENA
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: M.D
OtherOrganizationName:  
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OtherCredential:  
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Mailing Information
Address1: 36 LINCOLN RD
Address2:  
City: SCARSDALE
State: NY
PostalCode: 105837248
CountryCode: US
TelephoneNumber: 9147131077
FaxNumber: 9147134440
Practice Location
Address1: 234 E 149TH ST
Address2: LINCOLN HOSPITAL SD
City: BRONX
State: NY
PostalCode: 104515504
CountryCode: US
TelephoneNumber: 7185795000
FaxNumber: 7185794836
Other Information
ProviderEnumerationDate: 12/04/2006
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
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AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
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AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207R00000X203891NYY Allopathic & Osteopathic PhysiciansInternal Medicine 

No ID Information.


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