Individual
LUIS MARIO ASTUDILLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3131 GRAND CONCOURSE, SUITE 1B, BRONX, NY 10468-1442
(718) 295-7900
(718) 295-4160
Mailing address
PO BOX 837, HARTSDALE, NY 10530-0837
(718) 562-6570
(718) 346-5313
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
243249
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
350518195A
—
GA
Enumeration date
05/28/2006
Last updated
03/04/2011
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