Individual
REVATHY SUNDARAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
506 6TH ST, BROOKLYN, NY 11215-3609
(212) 256-3682
Mailing address
506 6TH ST, BROOKLYN, NY 11215-3609
(718) 780-3066
(718) 780-3515
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
138054
NY
2080P0207X
Pediatric Hematology & Oncology Physician
Primary
138054
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00788156
—
NY
Enumeration date
04/05/2006
Last updated
06/22/2023
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