Gudavalli, Prasad R.

Gudavalli, Prasad R. is an sole proprietor health care provider with primary practice located at 7702 - 16Th Ave , Brooklyn NY 11214-1002. He recently has only one registered license in Other Service Providers / Specialist, which is considered as his primary health care specialty. Gudavalli, Prasad R. can be contacted via phone (718) 645-2929.

Contact Information

Primary practice address
7702 - 16Th Ave Brooklyn NY 11214-1002
Phone: (718) 645-2929
Fax: (718) 621-4119
Website:
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Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X 128146 New York

Profile Details

NPI number 1497750046
LBN Legal business name Gudavalli, Prasad R.
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jun 20th, 2005
Last updated Nov 5th, 2012 - about 14 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1497750046 NPPES
New York MEDICAID 00366349
New York Other 0046803
New York Other 069508793
New York Other 1000016766
New York Other 4556190
New York Other OXFORD
New York Other 069508709
New York Other 07A361
New York Other 97367
New York Other 128146-A21
New York Other 0C0646

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