Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Sanju Padiyedathu Ittan, FNP-BC

Individual provider Family Nurse Practitioner · NPI 1457750200

Sanju Padiyedathu Ittan, FNP-BC is a Nurse Practitioner in Bronx, New York. Qualified in 2013, 13 years ago. Practices with Montefiore Medical Center, a 2,796-clinician group and offers telehealth. Licensed in New York.

Years since qualifying
13
Licensed in
NY
In the registry since
2014
What do these letters mean?
FNP-BC — Family Nurse Practitioner, Board Certified
A family nurse practitioner certified by the ANCC.

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Practice location Address checks out

1825 Eastchester Rd
Bronx, NY 10461-2301
Phone: (845) 709-0173
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence F338336 (NY)

Record details

NPI number1457750200
Entity typeIndividual (Type 1)
GenderMale
Credentials FNP-BC
Sole proprietorNo
NPI enumeratedAugust 18, 2014
Last updated in NPPESAugust 18, 2014

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2013 (13 years in practice)
Group practice Montefiore Medical Center — 2796 clinicians
Accepts Medicare assignment Not indicated
TelehealthOffers telehealth services
Practice locations2 on file with Medicare

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