Basic Information
Provider Information
NPI: 1669574653
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ACHARYA
FirstName: SATYA
MiddleName: SUNDERRAJAN
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 9293 STATE ROUTE 43
Address2: #B
City: STREETSBORO
State: OH
PostalCode: 442415374
CountryCode: US
TelephoneNumber: 3306261113
FaxNumber: 3306261133
Practice Location
Address1: 9293 STATE ROUTE 43
Address2: #B
City: STREETSBORO
State: OH
PostalCode: 442415374
CountryCode: US
TelephoneNumber: 3306261113
FaxNumber: 3306261133
Other Information
ProviderEnumerationDate: 09/01/2006
LastUpdateDate: 01/23/2014
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207R00000X35-076527OHY Allopathic & Osteopathic PhysiciansInternal Medicine 

No ID Information.


Home