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Organization
JAYAKUMAR THOTAMBILU, PHYSICIAN, P.C.
Active
Organization
JAYAKUMAR THOTAMBILU, PHYSICIAN, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAYAKUMAR THOTAMBILU M.D. (OWNER/PHYSICIAN)
(315) 592-4000
Entity
Organization
Contact information
Practice address
522 S 4TH ST, SUITE 1300, FULTON, NY 13069-2946
(315) 592-4000
(315) 593-3222
Mailing address
522 S 4TH ST, SUITE 1300, FULTON, NY 13069-2946
(315) 592-4001
(315) 593-3222
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
001219
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01805352
—
NY
Enumeration date
12/05/2011
Last updated
12/05/2011
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