Basic Information
| Provider Information | |||||||||
| NPI: | 1801115076 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | UTHAYASHANKAR | ||||||||
| FirstName: | ARUN | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 550 | ||||||||
| Address2: | 2 CATHARINESTREET, MID-HUDSON ANESTHESIOLOGISTS, PC | ||||||||
| City: | POUGHKEEPSIE | ||||||||
| State: | NY | ||||||||
| PostalCode: | 126020550 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8668852318 | ||||||||
| FaxNumber: | 8457902675 | ||||||||
| Practice Location | |||||||||
| Address1: | 70 DUBOIS STREET | ||||||||
| Address2: | ST. LUKES HOSPITAL | ||||||||
| City: | NEWBURGH | ||||||||
| State: | NY | ||||||||
| PostalCode: | 12550 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8455614400 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/26/2010 | ||||||||
| LastUpdateDate: | 08/12/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 08/12/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207L00000X | MT189107 | PA | N | Allopathic & Osteopathic Physicians | Anesthesiology | 207L00000X | 003538-1 | NY | N | Allopathic & Osteopathic Physicians | Anesthesiology | 207L00000X | 261214 | MA | Y | Allopathic & Osteopathic Physicians | Anesthesiology |
ID Information
| ID | Type | State | Issuer | Description | 03241572 | 05 | NY | MEDICAID |