Organization
NYHQ
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SUDHA V RAO (PHYSICIAN'S ASSISTANT)
(718) 670-1517
Entity
Organization
Contact information
Practice address
5645 MAIN ST, OBGYN, FLUSHING, NY 11355-5045
(718) 670-1517
Mailing address
215-18 85TH AVENUE, HOLLISHILLS, NEWYORK, NY 11428
Taxonomy
Speciality
Code
Description
License number
State
282N00000X
General Acute Care Hospital
Primary
008951
NY
Other
Enumeration date
04/06/2007
Last updated
08/22/2020
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