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Sushanth Shankar, MD
Student in an Organized Health Care Education/Training Program in Port Jefferson, New York
NPI 1871903435

Sushanth Shankar is a Student in an Organized Health Care Education/Training Program based in Port Jefferson, NY. Sushanth Shankar practices in Port Jefferson, NY and has the professional credentials of MD. The NPI Number for Sushanth Shankar is 1871903435 and holds a License No. (New York).

The current practice location address for Sushanth Shankar is 75 N Country Rd, Port Jefferson, NY and can be reached out via phone at 631-686-2517 and via fax at 631-686-7651.

Location: 75 N Country Rd, Port Jefferson, NY, 11777-2119
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1871903435
Provider Name
Sushanth Shankar
Credential
MD
Provider Entity Type
Individual
Gender
Male
Address
75 N Country Rd, Port Jefferson, NY, 11777-2119
Phone Number
631-686-2517
Fax Number
631-686-7651
Provider Enumeration Date
05/05/2014
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
75 N Country Rd
City
Port Jefferson
State
New York
Zip
11777-2119
Phone Number
631-686-2517
Fax Number
631-686-7651
person
Provider Business Mailing Address Details
Address
75 N Country Rd
City
Port Jefferson
State
New York
Zip
11777-2119
Phone Number
631-686-2517
Fax Number
631-686-7651
person
Provider's Taxonomy Details 1
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
390200000X
License No.
()
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
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