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General NPI Number Information
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NPI Number | 1831610625
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Entity Type | Individual
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Provider Name | EDUARDO ANDRES CALAGUA BEDOYA MD
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Gender | Male
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Dates
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Enumeration Date | 06/30/2017
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Last Update Date | 01/05/2023
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Provider Practice Location Address
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Address Line | 1 MEDICAL CENTER DR
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City | LEBANON
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State | NH
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Zip | 03756-1000
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Country | US
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Telephone | 603-650-5000
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Fax |
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Provider Business Mailing Address
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Address Line | 7901 BROADWAY RM C10-12
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City | ELMHURST
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State | NY
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Zip | 11373-1329
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Country | US
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Telephone | 718-334-3542
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Fax |
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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 | 21853
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License Number State | NH
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