SANJU PADIYEDATHU ITTAN

BRONX, NY
NPI1457750200
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy363LF0000X Nurse Practitioner, Family
(Licence: NY  F338336)
Enumeration Date2014-08-18
Last Update Date2014-08-18
Business Address
-- SANJU PADIYEDATHU ITTAN FNP-BC
1825 EASTCHESTER RD
BRONX, NY 10461-2301
Phone number: 845-709-0173
Mailing Address
-- SANJU PADIYEDATHU ITTAN FNP-BC
160 N MAIN ST APT 26B
NEW CITY, NY 10956-3811
Phone number: 845-709-0173
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