Healthcare Provider Details

I. General information

NPI: 1023069218
Provider Name (Legal Business Name): SUHAS MADHUKAR NAFDAY M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/13/2006
Last Update Date: 06/02/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1825 EASTCHESTER RD SUITE 725
BRONX NY
10461-2301
US

IV. Provider business mailing address

1825 EASTCHESTER RD SUITE 725
BRONX NY
10461-2301
US

V. Phone/Fax

Practice location:
  • Phone: 718-904-4105
  • Fax: 718-904-2659
Mailing address:
  • Phone: 718-904-4105
  • Fax: 718-904-2659

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number214431
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code2080N0001X
TaxonomyNeonatal-Perinatal Medicine Physician
License Number214431
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: