MEDICARE: DR. SUBHENDU KUNDU M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	209274	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1285629626
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SUBHENDU KUNDU M.D.

Provider Business Mailing Address
First Line	:	8132 256TH ST
Second Line	:
City	:	GLEN OAKS
State	:	NY
Zip	:	11004-1416
Country	:	US
Telephone Number	:	718-343-3401
Fax Number	:	718-347-0230

Provider Business Practice Location Address
First Line	:	1401 NEWKIRK AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11226-6521
Country	:	US
Telephone Number	:	718-283-1600
Fax Number	:	718-635-6020

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/13/2005
Last Update Date	:	07/08/2007

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