| Suja Johnkutty, M.d., P.l.l.c. | |
|
33 Walt Whitman Road Suite 201 Huntington Station NY 11746-4276 | |
| (631) 385-8558 | |
| (631) 385-8010 |
| Full Name | Suja Johnkutty, M.d., P.l.l.c. |
|---|---|
| Speciality | Psychiatry & Neurology - Neurology |
| Location | 33 Walt Whitman Road, Huntington Station, New York |
| Authorized Official Name and Position | Suja Johnkutty (PHYSICIAN) |
| Authorized Official Contact | 6313858558 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Suja Johnkutty, M.d., P.l.l.c. P.o. Box 224 Old Bethpage NY 11804-0224 Ph: (631) 385-8558 | Suja Johnkutty, M.d., P.l.l.c. 33 Walt Whitman Road Suite 201 Huntington Station NY 11746-4276 Ph: (631) 385-8558 |
| NPI Number | 1700098852 |
|---|---|
| Provider Enumeration Date | 05/03/2007 |
| Last Update Date | 05/16/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700098852 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | (* (Not Available)) | Secondary |
| 2084N0400X | Psychiatry & Neurology - Neurology | 216285 (New York) | Primary |
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