Provider Demographics
NPI:1730228800
Name:SATISH, MAGERY NAGARAJA (MD)
Entity type:Individual
Prefix:DR
First Name:MAGERY
Middle Name:NAGARAJA
Last Name:SATISH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 ROBERT CRES
Mailing Address - Street 2:
Mailing Address - City:STONY BROOK
Mailing Address - State:NY
Mailing Address - Zip Code:11790-3204
Mailing Address - Country:US
Mailing Address - Phone:631-689-3504
Mailing Address - Fax:
Practice Address - Street 1:99 HOLLYWOOD DR
Practice Address - Street 2:
Practice Address - City:SMITHTOWN
Practice Address - State:NY
Practice Address - Zip Code:11787-3135
Practice Address - Country:US
Practice Address - Phone:631-366-5800
Practice Address - Fax:631-366-2935
Is Sole Proprietor?:No
Enumeration Date:2007-02-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYNY1938822084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01457510Medicaid
NYGO7058Medicare UPIN
167581Medicare ID - Type Unspecified