MEDICARE: PRIYANKA BUDDHA M.B.B.S

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	390200000X	Student in an Organized Health Care Education/Training Program

General Provider Information

NPI Number	:	1770478331
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PRIYANKA BUDDHA M.B.B.S

Provider Business Mailing Address
First Line	:	1650 GRAND CONCOURSE BRONX-LEBANON HOSPITAL CENTER
Second Line	:	SUITE 6H
City	:	BRONX
State	:	NY
Zip	:	10457
Country	:	US
Telephone Number	:	718-960-1449
Fax Number	:

Provider Business Practice Location Address
First Line	:	1650 GRAND CONCOURSE BRONX-LEBANON HOSPITAL CENTER
Second Line	:	SUITE 6H
City	:	BRONX
State	:	NY
Zip	:	10457
Country	:	US
Telephone Number	:	718-960-1449
Fax Number	:

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

Provider Enumeration Date	:	06/12/2025
Last Update Date	:	03/12/2026

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