Individual
MAMATHA SUNDARESH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
190550
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01480813
—
NY
01
—
11-3563769
HORIZON HEALTHCARE NY
NY
01
—
190550-F15
HEALTH FIRST
NY
01
—
2563948
AETNA USHC HMO
NY
01
—
2698609
GHI
NY
01
—
300950401
HEALTH PLUS
NY
01
—
4604933
AETNA PPO
NY
01
—
BK00828-03
AMERICHOICE
NY
01
—
P2163738
OXFORD HEALTH PLANS
NY
Enumeration date
09/19/2005
Last updated
02/05/2013
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