Individual
DR. ASHA LATA PATNAIK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
26 RESEARCH WAY, EAST SETAUKET, NY 11733
(631) 444-0580
(631) 444-0562
Mailing address
26 RESEARCH WAY, EAST SETAUKET, NY 11733-3526
(631) 444-0580
(631) 444-0562
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
35-090755
OH
207R00000X
Internal Medicine Physician
5898
SD
207RR0500X
Rheumatology Physician
Primary
263442
NY
208M00000X
Hospitalist Physician
35.090755
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
35-090755
LICENSE
OH
01
—
5898
LICENSE
SD
05
—
6005490
—
SD
Enumeration date
09/20/2006
Last updated
07/17/2012
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