Individual
DR. SUNDAR JAGANNATH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
10 E 102ND ST, NEW YORK, NY 10029
(212) 241-6756
(212) 241-3908
Mailing address
1 GUSTAVE L LEVY PL # 3000, NEW YORK, NY 10029-6504
(212) 987-3100
(212) 731-5210
Taxonomy
Speciality
Code
Description
License number
State
207RX0202X
Medical Oncology Physician
Primary
209335
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01259874
—
NY
Enumeration date
10/10/2005
Last updated
02/26/2019
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