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Organization
S MADHUSOODANAN MD PC
Active
Organization
S MADHUSOODANAN MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SUBRAMONIAM MADHUSOODANAN MD (PRESIDENT S. MADHUSOODANAN MD PC)
(516) 371-1804
Entity
Organization
Contact information
Practice address
ST JOHNS EPISCOPAL HOSPITAL 327 BEACH CHANNEL DRIVE, FAR ROCKAWAY, NY 11691-1511
(718) 869-7000
Mailing address
249 BROADWAY, LAWRENCE, NY 11559-1511
(516) 371-1804
(516) 371-1804
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
138957
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02558818
—
NY
Enumeration date
11/04/2005
Last updated
03/17/2018
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