Organization
MADHAV A GUDI, MD, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MADHAV A GUDI MD (SOLE OWNER)
(718) 930-5230
Entity
Organization
Contact information
Practice address
8721 5TH AVE, BROOKLYN, NY 11209-5230
(718) 745-0860
Mailing address
1368 83RD ST, BROOKLYN, NY 11228-3035
(718) 745-0860
(347) 560-6040
Taxonomy
Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
Primary
122837
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002797722
—
NY
Enumeration date
10/22/2013
Last updated
10/22/2013
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