Individual
SANDEEP KUMAR ANNAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1000 MONTAUK HWY, WEST ISLIP, NY 11795-4927
(631) 736-4064
(631) 736-1332
Mailing address
3 BOYLE RD, SELDEN, NY 11784-4000
(631) 736-4064
(631) 736-1332
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
270386
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
AN-270386-6W
WORKERS COMPENSATION
NY
Enumeration date
04/09/2009
Last updated
07/11/2014
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