Most Relevant Information
Provider Data
| NPI Number: | 1003280470 |
| Provider Name: | STANLEY SEETARAM ANCILLARY PROVIDER |
| Entity Type: | Individual |
| Taxonomy Code: | 246RP1900X |
| Specialty: | Technician, Pathology |
| License Number: | NO LICENSE NUMBER |
Most Important Dates
| Enumeration Date: | 11/21/2015 |
| Last Updated: | 11/21/2015 |
Provider Practice Location
1263 FTELEY AVE
BRONX
NY
104722801
Practice Location Phone/Fax
| Phone: | 3477438258 |
| Fax: |
Provider Mailing Location
1263 FTELEY AVE
BRONX
NY
104722801
Provider Mailing Phone/Fax
| Phone: | 3477438258 |
| Fax: |