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NPI Code Detail

MEDICARE: DR. GOPALAKRISHNA KADIYALI UPADHYA M.D.

MEDICARE: DR. GOPALAKRISHNA KADIYALI UPADHYA M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12084P0800XPsychiatry Physician145583NY
22084P0800XPsychiatry Physician53590CT

General Provider Information

NPI Number : 1871631440
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. GOPALAKRISHNA KADIYALI UPADHYA M.D.
Provider Business Mailing Address
First Line : 510 N BROADWAY
Second Line :
City : WHITE PLAINS
State : NY
Zip : 10603-3217
Country : US
Telephone Number : 914-682-1752
Fax Number : 914-682-1752
Provider Business Practice Location Address
First Line : 510 N BROADWAY
Second Line :
City : WHITE PLAINS
State : NY
Zip : 10603-3217
Country : US
Telephone Number : 914-682-1752
Fax Number : 914-682-1752
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/03/2007
Last Update Date : 02/26/2016

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