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Organization

NEW YORK MEDICAL PRACTICE, PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
CHAITANYA KADIYALA MD (OWNER)
(646) 355-4450
Entity
Organization

Contact information

Practice address
9413 FLATLANDS AVE, BROOKLYN, NY 11236-3726
(646) 355-4450
Mailing address
565 PLANDOME RD UNIT 286, MANHASSET, NY 11030-1945

Taxonomy

Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
CERT# 4168
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
CERT# 4168
AMERICAN ASSOCIATION FOR ACCREDITATION OF AMBULATORY SURGERY FACILITIES, INC.
NY
Enumeration date
09/28/2016
Last updated
04/12/2017
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