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Individual

ACHUTA KUMAR GUDDATI

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
100 NICOLLS RD # T15053, STONY BROOK, NY 11794-0002
(631) 444-3655
Mailing address
100 NICOLLS RD # T15-053, STONY BROOK, NY 11794-0001
(631) 444-3655

Taxonomy

Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
080307
GA
207RH0003X
Hematology & Oncology Physician
Primary
315533
NY

Other

Enumeration date
07/26/2011
Last updated
07/25/2023
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