Individual
KRISHNAIYER SUBRAMANI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
500 MONTAUK HWY, SUITE B, WEST ISLIP, NY 11795-4418
(631) 422-4343
(631) 661-3775
Mailing address
500 MONTAUK HIGHWAY, SUTE B, WEST ISLIP, NY 11795
(631) 422-4343
(631) 661-3775
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
170817
NY
207RG0100X
Gastroenterology Physician
Primary
170817
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01191208
—
NY
Enumeration date
03/20/2006
Last updated
05/22/2008
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