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General NPI Number Information
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NPI Number | 1881767234
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Entity Type | Organization
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Legal Business Name | MADHU DAGLI MD PC
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Dates
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Enumeration Date | 11/15/2006
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Last Update Date | 10/11/2007
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Provider Practice Location Address
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Address Line | 944 NORTH BROADWAY SUITE 108
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City | YONKERS
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State | NY
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Zip | 10701
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Country | US
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Telephone | 914-476-1322
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Fax | 914-426-1346
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Provider Business Mailing Address
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Address Line | 944 NORTH BROADWAY SUITE 108
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City | YONKERS
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State | NY
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Zip | 10701
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Country | US
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Telephone | 914-476-1322
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Fax | 914-426-1346
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Authorized Official
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Title or Position | PRESIDENT
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Name | MADHU S DAG LI
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Credential | MD
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Telephone | 914-476-1322
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 139897
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License Number State | NY
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