Individual
NARAIN GOVENDER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2445 STATE ROUTE 30, TUPPER LAKE, NY 12986-2502
(518) 359-4217
Mailing address
PO BOX 766, SKANEATELES, NY 13152-0766
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
133121-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
133121-1
LICENSE
NY
Enumeration date
03/04/2008
Last updated
03/04/2008
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