Basic Information
| Provider Information | |||||||||
| NPI: | 1376046359 | ||||||||
| EntityType: | 1 | ||||||||
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| LastName: | POTU | ||||||||
| FirstName: | UMA | ||||||||
| MiddleName: | D | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1901 1AVE METROPOLITAN HOSPITAL | ||||||||
| Address2: | 7B14 | ||||||||
| City: | NY | ||||||||
| State: | NY | ||||||||
| PostalCode: | 100297404 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2124236271 | ||||||||
| FaxNumber: | 2124236338 | ||||||||
| Practice Location | |||||||||
| Address1: | 1901 1ST AVE METROPOLITAN HOSPITAL | ||||||||
| Address2: | 7B-14 | ||||||||
| City: | NEW YORK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 100297404 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2124236271 | ||||||||
| FaxNumber: | 2124236338 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/15/2018 | ||||||||
| LastUpdateDate: | 03/15/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 246XS1301X | 53827 | NY | Y | Technologists, Technicians & Other Technical Service Providers | Spec/Tech, Cardiovascular | Sonography |
No ID Information.