# MADISON MEDICAL PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1205139482
- **Authorized official:** MAYANK SHUKLA MD (MEDICAL DIRECTOR)
- **Authorized official phone:** (516) 395-2127

## Contact information

- **Practice address:** 315 MADISON AVE RM 2305, NEW YORK, NY 10017-5413
- **Practice address phone:** (516) 395-2127
- **Mailing address:** 315 MADISON AVE RM 2305, NEW YORK, NY 10017-5413

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207QS1201X | Sleep Medicine (Family Medicine) Physician | — | NULL | Yes |
| 207QS1201X | Sleep Medicine (Family Medicine) Physician | — | — | Yes |

## Other

- **Enumeration date:** 12/10/2010
- **Last updated:** 12/10/2010