Individual
ABHIJIT GUDIVADA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
988 1ST AVE, NEW YORK, NY 10022-4150
(212) 755-6632
Mailing address
450 WINSTON RD, JONESVILLE, NC 28642-2255
(336) 835-6407
(336) 526-8329
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
066511
NY
183500000X
Pharmacist
28154
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
066511
NY PHARMACIST LICENSE
NY
01
—
28154
NC PHARMACIST LICENSE
NC
Enumeration date
08/27/2018
Last updated
12/12/2022
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