1982805610 NPI number — SINNATHAMBY CARDIOLOGY SERVICES, INC.

Table of content: (NPI 1982805610)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1982805610 NPI number — SINNATHAMBY CARDIOLOGY SERVICES, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SINNATHAMBY CARDIOLOGY SERVICES, INC.
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:
SINNATHAMBY & SEQUIRA CARDIOLOGY
Provider Other Organization Name Type Code:
4
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:
1982805610
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/10/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
61 DARST RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
DAYTON
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
45440-3407
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
937-424-3589
Provider Business Mailing Address Fax Number:
937-424-0093

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5538 PHILADELPHIA DR
Provider Second Line Business Practice Location Address:
SUITE 4
Provider Business Practice Location Address City Name:
DAYTON
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
45415-3062
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
937-424-3589
Provider Business Practice Location Address Fax Number:
937-424-0093
Provider Enumeration Date:
05/30/2007

Additional Information

Authorized Official

Authorized Official Last Name:
HUNT
Authorized Official First Name:
MELYSSA
Authorized Official Middle Name:
DAWN
Authorized Official Title or Position:
PRACTICE MANAGER
Authorized Official Telephone Number:
937-701-2294

Provider Taxonomy Codes

  • Taxonomy code: 207RC0000X , with the licence number:  061440 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 2736641 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".




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