Individual
RADHA MAGDALEEN BOODRAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ACUTE CARE NP
Contact information
Practice address
1991 MARCUS AVE, SUITE 310, NEW HYDE PARK, NY 11042-2057
(516) 472-6012
Mailing address
1991 MARCUS AVE, SUITE 310, NEW HYDE PARK, NY 11042-2057
(516) 472-6012
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
5107311
NY
363LA2100X
Acute Care Nurse Practitioner
Primary
4306021
NY
Other
Enumeration date
04/02/2012
Last updated
04/02/2012
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