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General NPI Number Information
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NPI Number | 1720200520
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Entity Type | Individual
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Provider Name | VASUNDHARA KALASAPUDI M.D
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Gender | Female
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Dates
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Enumeration Date | 05/02/2007
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Last Update Date | 07/09/2007
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Provider Practice Location Address
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Address Line | 99 HILLSIDE AVE STE O
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City | WILLISTON PARK
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State | NY
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Zip | 11596-2350
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Country | US
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Telephone | 516-859-5125
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Fax | 516-746-4244
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Provider Business Mailing Address
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Address Line | 208 PARKWAY DR
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City | ROSLYN HEIGHTS
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State | NY
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Zip | 11577-2737
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Country | US
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Telephone | 516-626-3032
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Fax | 516-706-1960
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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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 219449
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License Number State | NY
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