Individual
MAYADEVI SASANKAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
510 ROUTE 6 AND 209, SUITE 8, MILFORD, PA 18337-7615
(570) 296-5950
(570) 296-1066
Mailing address
510 ROUTE 6 AND 209, SUITE 8, MILFORD, PA 18337-7615
(570) 296-5950
(570) 296-1066
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
228755
NY
208000000X
Pediatrics Physician
Primary
MD435628
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02496784
—
NY
05
—
102215516 0001
—
PA
Enumeration date
06/29/2007
Last updated
03/03/2009
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