Basic Information
| Provider Information | |||||||||
| NPI: | 1861432304 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | NEPHROLOGY ASSOCIATES OF WATERTOWN PC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 19316 US ROUTE 11 STE B | ||||||||
| Address2: | |||||||||
| City: | WATERTOWN | ||||||||
| State: | NY | ||||||||
| PostalCode: | 136016736 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3157824207 | ||||||||
| FaxNumber: | 3157828699 | ||||||||
| Practice Location | |||||||||
| Address1: | 19316 US ROUTE 11 | ||||||||
| Address2: | STE B | ||||||||
| City: | WATERTOWN | ||||||||
| State: | NY | ||||||||
| PostalCode: | 136016735 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3157820136 | ||||||||
| FaxNumber: | 3157827212 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/06/2006 | ||||||||
| LastUpdateDate: | 12/13/2017 | ||||||||
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| AuthorizedOfficialLastName: | SINDHU | ||||||||
| AuthorizedOfficialFirstName: | KHALID | ||||||||
| AuthorizedOfficialMiddleName: | P | ||||||||
| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 3157820136 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RN0300X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | Nephrology |
No ID Information.