Organization
43RD ST FAMILY PRACTICE PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DURGA MADDINENI (MD)
(718) 392-2220
Entity
Organization
Contact information
Practice address
4543 43RD ST, SUNNYSIDE, NY 11104-2609
(718) 392-2220
Mailing address
4543 43RD ST, SUNNYSIDE, NY 11104-2609
(718) 392-2220
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
227095
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02462119
—
NY
Enumeration date
08/20/2006
Last updated
03/31/2016
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