Individual
RAGHU IDUPUGANTI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
259 1ST ST, MINEOLA, NY 11501-3957
(516) 663-2216
Mailing address
255 W MICHIGAN AVE, JACKSON, MI 49201-2218
(800) 242-1131
(517) 787-4146
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
238871
NY
Other
Enumeration date
07/07/2006
Last updated
08/29/2022
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