Healthcare Provider Details

I. General information

NPI: 1407894884
Provider Name (Legal Business Name): HARADAYA K HEGDE M,D.
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 06/04/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

330 E 33RD ST APT#10L
NEW YORK NY
10016-9466
US

IV. Provider business mailing address

330 E 33RD ST APT#10L
NEW YORK NY
10016-9466
US

V. Phone/Fax

Practice location:
  • Phone: 212-889-7861
  • Fax: 212-889-7861
Mailing address:
  • Phone: 212-889-7861
  • Fax: 212-889-7861

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207PE0004X
TaxonomyEmergency Medical Services (Emergency Medicine) Physician
License Number136042
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code2085R0203X
TaxonomyTherapeutic Radiology Physician
License Number136042
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: