Healthcare Provider Details

I. General information

NPI: 1609811637
Provider Name (Legal Business Name): MATTHEW GUDIS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/16/2006
Last Update Date: 08/14/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14 CAROL DRIVE
MOUNT KISCO NY
10549
US

IV. Provider business mailing address

14 CAROL DRIVE
MOUNT KISCO NY
10549
US

V. Phone/Fax

Practice location:
  • Phone: 914-666-5383
  • Fax: 718-548-1161
Mailing address:
  • Phone: 914-666-5383
  • Fax: 718-548-1161

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number114270
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: