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Organization
NERLIGE BASAVARAJU PHYSICIAN, P.C.
Active
Organization
NERLIGE BASAVARAJU PHYSICIAN, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. NERLIGE BASAVARAJU MD (CEO)
(516) 713-4465
Entity
Organization
Contact information
Practice address
68 HAUPPAUGE RD, COMMACK, NY 11725-4403
(516) 713-4465
Mailing address
378 ELM DR, ROSLYN, NY 11576-3013
(516) 713-4465
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
117319
NY
Other
Enumeration date
08/30/2017
Last updated
08/30/2017
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