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NPI Code Detail

MEDICARE: DR. MADHAVI LATHA NAGAPAGA M.D

MEDICARE: DR. MADHAVI LATHA NAGAPAGA 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
1207Q00000XFamily Medicine Physician276085NY

General Provider Information

NPI Number : 1578795266
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MADHAVI LATHA NAGAPAGA M.D
Provider Business Mailing Address
First Line : 2045 49TH ST
Second Line :
City : ASTORIA
State : NY
Zip : 11105-1205
Country : US
Telephone Number : 646-808-9572
Fax Number : 347-286-3991
Provider Business Practice Location Address
First Line : 2510 30TH AVE
Second Line :
City : LONG ISLAND CITY
State : NY
Zip : 11102-2448
Country : US
Telephone Number : 718-932-1000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/14/2009
Last Update Date : 01/07/2026

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