Individual
KRISHNA R S GUJAVARTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
49 DOLPHIN LANE EAST, COPIAGUE, NY 11726
(631) 331-0028
(631) 608-3387
Mailing address
49 DOLPHIN LANE EAST, COPIAGUE, NY 11726-5415
(631) 331-0028
(631) 608-3387
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
141407
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00604040
—
NY
Enumeration date
08/07/2006
Last updated
07/08/2007
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