Individual
PREM THANARATNAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
111 E 210TH ST, BRONX, NY 10467-2401
(718) 696-2583
(718) 881-5074
Mailing address
111 E 210TH ST, BRONX, NY 10467-2401
(718) 696-2583
(718) 881-5074
Taxonomy
Speciality
Code
Description
License number
State
2085R0204X
Vascular & Interventional Radiology Physician
Primary
22108
NV
Other
Enumeration date
04/02/2015
Last updated
10/04/2023
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