| S Madhusoodanan Md Pc | |
|
St Johns Episcopal Hospital 327 Beach Channel Drive Far Rockaway NY 11691-1511 | |
| (718) 869-7000 | |
| Not Available |
| Full Name | S Madhusoodanan Md Pc |
|---|---|
| Speciality | Psychiatry & Neurology - Psychiatry |
| Location | St Johns Episcopal Hospital 327 Beach Channel Drive, Far Rockaway, New York |
| Authorized Official Name and Position | Subramoniam Madhusoodanan (PRESIDENT S. MADHUSOODANAN MD PC) |
| Authorized Official Contact | 5163711804 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| S Madhusoodanan Md Pc 249 Broadway Lawrence NY 11559-1511 Ph: (516) 371-1804 | S Madhusoodanan Md Pc St Johns Episcopal Hospital 327 Beach Channel Drive Far Rockaway NY 11691-1511 Ph: (718) 869-7000 |
| NPI Number | 1629069901 |
|---|---|
| Provider Enumeration Date | 11/04/2005 |
| Last Update Date | 03/17/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629069901 | NPI | - | NPPES |
| 02558818 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | 138957 (New York) | Primary |
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