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Individual

MR. NERLIGE BASAVARAJU

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
45 MAIN ST, SUITE 408, BROOKLYN, NY 11201-1000
(866) 662-4560
(347) 328-0333
Mailing address
45 MAIN ST, SUITE 408, BROOKLYN, NY 11201-1000
(866) 662-4560
(347) 328-0333

Taxonomy

Speciality
Code
Description
License number
State
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
117319
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
02229674
NY
Enumeration date
11/03/2005
Last updated
06/02/2014
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