Organization
SUJA JOHNKUTTY, M.D., P.L.L.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SUJA JOHNKUTTY M.D. (PHYSICIAN)
(631) 385-8558
Entity
Organization
Contact information
Practice address
33 WALT WHITMAN ROAD, SUITE 201, HUNTINGTON STATION, NY 11746-4276
(631) 385-8558
(631) 385-8010
Mailing address
P.O. BOX 224, OLD BETHPAGE, NY 11804-0224
(631) 385-8558
(631) 385-8010
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
216285
NY
2084N0400X
Neurology Physician
—
—
Other
Enumeration date
05/03/2007
Last updated
05/16/2011
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