Individual
SUBHASH R VISWANATHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
555 N BROADWAY, JERICHO, NY 11753-2134
(516) 597-5070
(516) 597-5067
Mailing address
555 N BROADWAY, JERICHO, NY 11753-2134
(516) 597-5070
(516) 597-5067
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
248884
NY
207P00000X
Emergency Medicine Physician
25MA07825900
NJ
207P00000X
Emergency Medicine Physician
Primary
C149731
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0053783
—
NJ
Enumeration date
07/29/2005
Last updated
03/08/2024
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