Individual
DR. GAUTHAM KADIYALI UPADHYA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD, MPH
Contact information
Practice address
1161 VICTORY BLVD, STATEN ISLAND, NY 10301-3621
(718) 818-7425
(855) 448-7807
Mailing address
1161 VICTORY BLVD, STATEN ISLAND, NY 10301-3621
(718) 818-7425
(855) 448-7807
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
294581
NY
246XC2901X
Cardiovascular Invasive Specialist/Technologist
Primary
—
—
Other
Enumeration date
07/02/2015
Last updated
02/03/2025
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