Dr. Sudharam Idupuganti, MD
Psychiatry & Neurology, Psychiatry in Brooklyn, NY. Individual provider (NPI-1).
NPI number1790742005
StatusActive
Last updated in NPPESSep 30, 2011
Details
- NPI
- 1790742005
- Entity type
- Individual (NPI-1)
- Name
- Dr. Sudharam Idupuganti
- Credential
- MD
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Apr 28, 2006
- Last updated
- Sep 30, 2011
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology, Psychiatry | 138851 | NY | Yes |
Practice location
585 Bay Ridge PkwyBrooklyn, NY 11209-3309
Phone 718-921-1001 · Fax 718-921-1001
Mailing address
585 Bay Ridge PkwyBrooklyn, NY 11209-3309
Phone 718-921-1001 · Fax 718-921-1001
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