Individual
REVATHY SUNDARAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
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
Update your record
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