Individual
PAUL PROMADHATTVEDI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
255 FORT WASHINGTON AVE APT 41, NEW YORK, NY 10032-1252
(917) 328-3232
Mailing address
255 FORT WASHINGTON AVE, APT 41, NEW YORK, NY 10032-1229
(917) 328-3232
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
301528
NY
390200000X
Student in an Organized Health Care Education/Training Program
MT212736
PA
Other
Enumeration date
05/04/2017
Last updated
12/15/2019
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