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General NPI Number Information
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NPI Number | 1861649519
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Entity Type | Organization
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Legal Business Name | MUDGIL DERMATOLOGY, P.C.
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Dates
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Enumeration Date | 08/25/2008
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Last Update Date | 05/29/2025
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Provider Practice Location Address
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Address Line | 30 5TH AVE APT 1D
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City | NEW YORK
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State | NY
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Zip | 10011-8803
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Country | US
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Telephone | 212-228-2526
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Fax | 212-228-2735
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Provider Business Mailing Address
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Address Line | 30 5TH AVE APT 1D
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City | NEW YORK
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State | NY
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Zip | 10011-8803
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Country | US
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Telephone | 212-228-2526
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Fax | 212-228-2735
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Authorized Official
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Title or Position | PRESIDENT
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Name | ADARSH VIJAY MUDGIL
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Credential | MD
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Telephone | 631-334-7786
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207ZP0102X
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Taxonomy Name | Anatomic Pathology & Clinical Pathology Physician
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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 | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number |
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License Number State |
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