Organization
SAVERIMUTTU MEDICAL PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JESSIE K SAVERIMUTTU M.D (MANAGING DIRECTOR)
(646) 417-0747
Entity
Organization
Contact information
Practice address
2435 VICTORY BLVD, STATEN ISLAND, NY 10314-6633
(646) 275-4334
Mailing address
398 GOWER ST, STATEN ISLAND, STATEN ISLAND, NY 10314-5333
(646) 275-4334
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03179884
—
NY
01
—
060QHI
BLUE CROSS BLUESHIELD
—
01
—
1750734
GHI
—
01
—
3125050
UNITED HEALTH CARE
—
01
—
5190872
CIGNA
—
01
—
9235428
ADENA
—
01
—
SEIU142177
SEIU
—
Enumeration date
09/18/2012
Last updated
09/18/2012
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