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General NPI Number Information
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NPI Number | 1033679717
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Entity Type | Individual
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Provider Name | CHANDANA PAPUDESU MD
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Gender | Female
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Dates
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Enumeration Date | 03/20/2019
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Last Update Date | 05/10/2024
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Provider Practice Location Address
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Address Line | 100 E 77TH ST
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City | NEW YORK
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State | NY
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Zip | 10075-1850
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Country | US
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Telephone | 212-434-2000
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Fax |
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Provider Business Mailing Address
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Address Line | 7860 SAINT MARLO FAIRWAY DR
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City | DULUTH
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State | GA
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Zip | 30097-1699
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Country | US
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Telephone | 478-357-2737
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Fax | 304-293-5160
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 326605
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License Number State | NY
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