Individual
DR. SUSHEEL KUMAR KODALI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
161 FORT WASHINGTON AVE, NEW YORK, NY 10032-3729
(212) 342-3616
Mailing address
630 W 168TH ST, BOX 4, NEW YORK, NY 10032-3725
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
232282
NY
207RI0011X
Interventional Cardiology Physician
Primary
232282
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02676460
—
NY
Enumeration date
10/25/2006
Last updated
07/19/2024
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