1902922792 NPI number — T V SESHAN M D P C

Table of content: (NPI 1902922792)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1902922792 NPI number — T V SESHAN M D P C

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
T V SESHAN M D P C
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
NEURO ALERT MONITORING SERVICES
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1902922792
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/29/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
399 KNOLLWOOD ROAD
Provider Second Line Business Mailing Address:
SUITE 108
Provider Business Mailing Address City Name:
WHITE PLAINS
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
10603-1916
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
914-949-8501
Provider Business Mailing Address Fax Number:
914-949-8502

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
399 KNOLLWOOD RD.
Provider Second Line Business Practice Location Address:
SUITE 108
Provider Business Practice Location Address City Name:
WHITE PLAINS
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10603
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
914-949-8501
Provider Business Practice Location Address Fax Number:
914-949-8502
Provider Enumeration Date:
03/22/2007

Additional Information

Authorized Official

Authorized Official Last Name:
SESHAN
Authorized Official First Name:
SURYA
Authorized Official Middle Name:
V
Authorized Official Title or Position:
OWNER / AUTHORIZED OFFICIAL
Authorized Official Telephone Number:
212-746-6455

Provider Taxonomy Codes

  • Taxonomy code: 208100000X , with the licence number:  144429 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 208100000X , with the licence number: 035937 , registered in the state of CT ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 490430 . This is a "AETNA ID#" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 66A221 . This is a "BC-BS ID#" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: WS1079 . This is a "OXFORD ID#" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 109674700 . This is a "US DEPT OF LABOR ID#" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 70420 . This is a "MAGNACARE ID#" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".




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