1144635533 NPI number — MR. NEIL SURAJ PANDYA M.D.

Table of content: MR. NEIL SURAJ PANDYA M.D. (NPI 1144635533)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1144635533 NPI number — MR. NEIL SURAJ PANDYA M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
PANDYA
Provider First Name:
NEIL
Provider Middle Name:
SURAJ
Provider Name Prefix Text:
MR.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
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:
1144635533
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/18/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
01/29/2015
NPI Reactivation Date:
02/18/2015

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
P. O. BOX 673, 601 ELMWOOD AVENUE
Provider Second Line Business Mailing Address:
UNIVERSITY OF ROCHESTER MEDICAL CENTER
Provider Business Mailing Address City Name:
ROCHESTER
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
14692
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
585-275-2762
Provider Business Mailing Address Fax Number:
585-273-1254

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
601 ELMWOOD AVENUE
Provider Second Line Business Practice Location Address:
UNIVERSITY OF ROCHESTER MEDICAL CENTER
Provider Business Practice Location Address City Name:
ROCHESTER
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
14692
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
585-275-2762
Provider Business Practice Location Address Fax Number:
585-273-1254
Provider Enumeration Date:
06/25/2014

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 390200000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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