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General NPI Number Information
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NPI Number | 1013374016
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Entity Type | Organization
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Legal Business Name | SUDHIR GADH, LLC
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Dates
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Enumeration Date | 01/21/2016
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Last Update Date | 01/21/2016
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Provider Practice Location Address
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Address Line | 432 E 149TH ST
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City | BRONX
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State | NY
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Zip | 10455-1343
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Country | US
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Telephone | 718-673-9337
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Fax | 718-310-3303
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Provider Business Mailing Address
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Address Line | 370 E 149TH ST 3RD FLOOR SUITE 8
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City | BRONX
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State | NY
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Zip | 10455-3900
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Country | US
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Telephone | 718-666-7456
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Fax | 718-310-3303
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Authorized Official
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Title or Position | OWNER
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Name | MR. SUDHIR GADH
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Credential | MD
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Telephone | 718-666-7456
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 243760
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License Number State | NY
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