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General NPI Number Information
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NPI Number | 1265294979
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Entity Type | Organization
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Legal Business Name | YOGENDRA UPADHYAY MD PC
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Dates
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Enumeration Date | 01/29/2024
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Last Update Date | 01/29/2024
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Provider Practice Location Address
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Address Line | 400 MONTAUK HWY STE 109
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City | WEST ISLIP
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State | NY
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Zip | 11795-4429
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Country | US
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Telephone | 516-480-5578
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Fax | 516-801-4361
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Provider Business Mailing Address
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Address Line | 400 MONTAUK HWY STE 109
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City | WEST ISLIP
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State | NY
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Zip | 11795-4429
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Country | US
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Telephone | 516-480-5578
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Fax | 516-801-4361
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Authorized Official
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Title or Position | PRESIDENT
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Name | YOGENDRA UPADHYAY
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Credential | MD
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Telephone | 516-480-5578
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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