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General NPI Number Information
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NPI Number | 1942031141
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Entity Type | Organization
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Legal Business Name | GAIDAMAKA PSYCHIATRY LLC
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Dates
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Enumeration Date | 08/09/2024
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Last Update Date | 08/13/2024
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Provider Practice Location Address
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Address Line | 6 KILMER RD # 1213
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City | EDISON
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State | NJ
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Zip | 08817-2432
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Country | US
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Telephone | 215-301-8873
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Fax |
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Provider Business Mailing Address
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Address Line | 9 BANFF CT
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City | MORGANVILLE
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State | NJ
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Zip | 07751-1680
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Country | US
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Telephone | 215-301-8873
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | KATERYNA GAIDAMAKA
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Credential | MD
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Telephone | 215-301-8873
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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 |
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License Number State |
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