Individual
DR. ADVAITH BONGU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
622 W 168TH ST, NEW YORK, NY 10032-3720
(212) 305-0914
(212) 305-4343
Mailing address
622 W 168TH ST, NEW YORK, NY 10032-3720
(212) 305-0914
(212) 305-4343
Taxonomy
Speciality
Code
Description
License number
State
204F00000X
Transplant Surgery Physician
Primary
283949
NY
Other
Enumeration date
06/08/2009
Last updated
04/26/2018
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