Basic Information
Provider Information
NPI: 1407897754
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ANAND
FirstName: SATISH
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 300 BAY SHORE RD
Address2:  
City: NORTH BABYLON
State: NY
PostalCode: 117032823
CountryCode: US
TelephoneNumber: 6315862700
FaxNumber: 6315863524
Practice Location
Address1: 300 BAY SHORE RD
Address2:  
City: NORTH BABYLON
State: NY
PostalCode: 117032823
CountryCode: US
TelephoneNumber: 6315862700
FaxNumber: 6315863524
Other Information
ProviderEnumerationDate: 06/09/2006
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: X
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207R00000X124963NYY Allopathic & Osteopathic PhysiciansInternal Medicine 

ID Information
IDTypeStateIssuerDescription
0080847505NY MEDICAID


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