Nerlige Basavaraju Physician, P.C.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

117319 Issued in NY

Legal business name

NERLIGE BASAVARAJU PHYSICIAN, P.C.

Practice address

68 Hauppauge Rd
Commack, NY 11725-4403

Phone

(516) 713-4465

NPI assigned

Aug 30, 2017

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Nerlige Basavaraju, MD

Title

Ceo

Phone

(516) 713-4465

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1504051200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1504051200000",
    "number": "1427576370",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "378 ELM DR",
            "city": "ROSLYN",
            "state": "NY",
            "postal_code": "115763013",
            "telephone_number": "516-713-4465"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "68 HAUPPAUGE RD",
            "city": "COMMACK",
            "state": "NY",
            "postal_code": "117254403",
            "telephone_number": "516-713-4465"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NERLIGE BASAVARAJU PHYSICIAN, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-08-30",
        "last_updated": "2017-08-30",
        "status": "A",
        "authorized_official_last_name": "BASAVARAJU",
        "authorized_official_first_name": "NERLIGE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "516-713-4465",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "117319",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Internal Medicine Physician in Commack, NY
• Providers in Commack, NY by specialty
• Internal Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.