Basic Information
Provider Information
NPI: 1487393070
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: DEVKOTA
FirstName: SAUGAT
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1901 FIRST AVENUE, 15TH FLOOR, MAIN BUILDING,15B, 15-1B
Address2:  
City: MANHATTAN
State: NY
PostalCode: 10029
CountryCode: US
TelephoneNumber: 2124236271
FaxNumber:  
Practice Location
Address1: 1901 FIRST AVENUE
Address2:  
City: NEW YORK
State: NY
PostalCode: 10029
CountryCode: US
TelephoneNumber: 3462194070
FaxNumber:  
Other Information
ProviderEnumerationDate: 06/01/2022
LastUpdateDate: 06/01/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 06/01/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
390200000X  Y Student, Health CareStudent in an Organized Health Care Education/Training Program 

No ID Information.


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