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General NPI Number Information
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NPI Number | 1851403935
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Entity Type | Organization
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Legal Business Name | SATHISH R. MODUGU MEDICAL PC
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Dates
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Enumeration Date | 08/31/2006
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Last Update Date | 03/21/2023
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Provider Practice Location Address
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Address Line | 280 N CENTRAL AVE SUITE 204
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City | HARTSDALE
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State | NY
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Zip | 10530-1832
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Country | US
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Telephone | 914-681-9750
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Fax | 914-681-9755
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Provider Business Mailing Address
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Address Line | 280 N CENTRAL AVE SUITE 204
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City | HARTSDALE
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State | NY
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Zip | 10530-1832
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Country | US
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Telephone | 914-681-9750
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Fax | 914-681-9755
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. SATHISH REDDY MODUGU
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Credential | M. D.
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Telephone | 914-681-9750
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2081P2900X
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Taxonomy Name | Pain Medicine (Physical Medicine & Rehabilitation) Physician
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License Number |
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License Number State |
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