Basic Information
| Provider Information | |||||||||
| NPI: | 1770980443 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | AYAN | ||||||||
| FirstName: | SAANKRITYA | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| OtherOrganizationName: | |||||||||
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| OtherLastName: | AYAN | ||||||||
| OtherFirstName: | SAANKRITYA | ||||||||
| OtherMiddleName: | |||||||||
| OtherNamePrefix: | DR. | ||||||||
| OtherNameSuffix: | |||||||||
| OtherCredential: | M.D | ||||||||
| OtherLastNameType: | 2 | ||||||||
| Mailing Information | |||||||||
| Address1: | 3450 WAYNE AVE | ||||||||
| Address2: | APT 25S | ||||||||
| City: | BRONX | ||||||||
| State: | NY | ||||||||
| PostalCode: | 104672510 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9173701215 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 111 E 210TH ST | ||||||||
| Address2: | HOUSE STAFF OFFICE | ||||||||
| City: | BRONX | ||||||||
| State: | NY | ||||||||
| PostalCode: | 104672401 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7189204806 | ||||||||
| FaxNumber: | 7189208403 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/24/2014 | ||||||||
| LastUpdateDate: | 11/24/2014 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 390200000X | 90275 | NY | Y | Student, Health Care | Student in an Organized Health Care Education/Training Program |
No ID Information.