Individual
DR. BHANUMATHY VINAYAGASUNDARAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
640 HAWKINS AVENUE, LAKE RONKONKOMA, NY 11779
(631) 737-0100
(631) 471-1117
Mailing address
55 WATER ST FL 2, NEW YORK, NY 10041-0010
(646) 680-2888
(516) 542-5556
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
240741
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02879927
—
NY
Enumeration date
08/11/2006
Last updated
09/22/2025
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