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SUBRAMANIAM SADHASIVAM

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1138 BROADWAY ST, ELMIRA, NY 14904-2502
(607) 734-2695
(607) 734-2917
Mailing address
571 SAINT JOSEPHS BLVD FL 2, ELMIRA, NY 14901-3230
(607) 271-2050
(607) 873-1244

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
257501
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
02922407
NY
Enumeration date
07/04/2006
Last updated
11/30/2020
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