Provider Demographics
NPI:1902896764
Name:ANAND, SUMEET K (MD)
Entity Type:Individual
Prefix:
First Name:SUMEET
Middle Name:K
Last Name:ANAND
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 249
Mailing Address - Street 2:
Mailing Address - City:BRIGHTWATERS
Mailing Address - State:NY
Mailing Address - Zip Code:11718-0249
Mailing Address - Country:US
Mailing Address - Phone:631-647-9100
Mailing Address - Fax:631-647-9099
Practice Address - Street 1:1111 MONTAUK HWY STE 2-4
Practice Address - Street 2:
Practice Address - City:WEST ISLIP
Practice Address - State:NY
Practice Address - Zip Code:11795-4910
Practice Address - Country:US
Practice Address - Phone:631-647-9100
Practice Address - Fax:631-647-9099
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-24
Last Update Date:2021-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY60229976207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02369650Medicaid
7130R1OtherEMPIRE BC/BS
NY02369650Medicaid
7130R1OtherEMPIRE BC/BS