Individual
MRS. SUDHA K OMPRAKASH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
355 BARD AVE, STATEN ISLAND, NY 10310-1664
(718) 818-3260
(718) 818-3713
Mailing address
31 NORMAN PL, STATEN ISLAND, NY 10309-4015
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
005194
NY
Other
Enumeration date
05/11/2007
Last updated
07/08/2007
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