Individual provider · Type 1 NPI

Sanju Padiyedathu Ittan, FNP-BC

Family Nurse Practitioner · Bronx, NY

NPI number 1457750200 Active

Practice location

1825 Eastchester Rd
Bronx, NY 10461-2301

Mailing address

160 N Main St Apt 26B
New City, NY 10956-3811

Specialties and licenses

TaxonomyCodeLicense
Family Nurse Practitioner Primary 363LF0000XF338336 (NY)

Family Nurse Practitioner: Definition to come...

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About NPI 1457750200

Sanju Padiyedathu Ittan, FNP-BC's National Provider Identifier is 1457750200, issued on Aug 18, 2014. The primary taxonomy on file is Family Nurse Practitioner (363LF0000X), and the practice location is in Bronx, NY. The record was last updated on Aug 18, 2014.