Provider Demographics
NPI:1861585077
Name:PERINBASEKAR, SARADHA DEVI (MD)
Entity type:Individual
Prefix:DR
First Name:SARADHA
Middle Name:DEVI
Last Name:PERINBASEKAR
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 1:670 STONELEIGH AVE
Mailing Address - Street 2:
Mailing Address - City:CARMEL
Mailing Address - State:NY
Mailing Address - Zip Code:10512-3997
Mailing Address - Country:US
Mailing Address - Phone:845-278-2929
Mailing Address - Fax:
Practice Address - Street 1:670 STONELEIGH AVE
Practice Address - Street 2:BLDG665 SUITE 209
Practice Address - City:CARMEL
Practice Address - State:NY
Practice Address - Zip Code:10512-3997
Practice Address - Country:US
Practice Address - Phone:845-278-2929
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY170938207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01177086Medicaid
NY38K232Medicare ID - Type Unspecified
NY01177086Medicaid