Individual
MRS. AYESHA MURIAM SOORIABALAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
211 CHURCH STREET, SARATOGA SPRINGS, NY 12866
(518) 587-1141
(518) 587-1152
Mailing address
454 MAPLE AVE, SARATOGA SPRINGS, NY 12866-5532
(518) 587-1141
(518) 587-1152
Taxonomy
Speciality
Code
Description
License number
State
207RH0002X
Hospice and Palliative Medicine (Internal Medicine) Physician
Primary
257948
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PENDING
—
NY
Enumeration date
07/10/2008
Last updated
12/14/2022
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