Healthcare Provider Details

I. General information

NPI: 1205856754
Provider Name (Legal Business Name): ROBERT A UDESKY MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: ROBERT UDESKY MD

II. Dates (important events)

Enumeration Date: 07/20/2006
Last Update Date: 05/27/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

145 E 32ND ST
NEW YORK NY
10016
US

IV. Provider business mailing address

145 E 32ND ST
NEW YORK NY
10016
US

V. Phone/Fax

Practice location:
  • Phone: 212-725-5300
  • Fax: 212-725-5590
Mailing address:
  • Phone: 212-725-5300
  • Fax: 212-725-5590

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number123734
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number123734
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: