Individual
KAUSHAL B NANAVATI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
475 IRVING AVE, SUITE 200, SYRACUSE, NY 13210-1756
(315) 464-4686
(315) 464-7106
Mailing address
475 IRVING AVE, SUITE 200, SYRACUSE, NY 13210-1756
(315) 464-4686
(315) 464-7106
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
214594
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01972090
—
NY
Enumeration date
07/25/2006
Last updated
08/21/2013
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