Individual
SANDEEP PRUTHI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
41 MADISON AVE, NEW YORK, NY 10010-2202
(914) 236-4121
Mailing address
41 MADISON AVE, NEW YORK, NY 10010-2202
(914) 236-4121
(914) 709-4858
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
277844
NY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
113368
SID # 113368
CA
Enumeration date
02/28/2012
Last updated
07/10/2023
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