Individual
ANANTHRAJ SUBRAMANYA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
234 E 149TH ST, BRONX, NY 10451-5504
(732) 762-2122
Mailing address
2562 LACONIA AVE, BRONX, NY 10469-1409
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
29888
WV
Other
Enumeration date
07/24/2017
Last updated
09/25/2020
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