Suresh Undavia, Md Pllc | |
114 Clayton Ave Vestal NY 13850-2430 | |
(607) 785-4277 | |
(607) 785-3617 |
Full Name | Suresh Undavia, Md Pllc |
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Speciality | Psychiatry & Neurology |
Location | 114 Clayton Ave, Vestal, New York |
Authorized Official Name and Position | Suresh Undavia (PSYCHIATRIST) |
Authorized Official Contact | 6077854277 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Suresh Undavia, Md Pllc Po Box 645 Vestal NY 13851-0645 Ph: (607) 785-4277 | Suresh Undavia, Md Pllc 114 Clayton Ave Vestal NY 13850-2430 Ph: (607) 785-4277 |
NPI Number | 1154582005 |
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Provider Enumeration Date | 06/23/2008 |
Last Update Date | 06/23/2008 |
Medicare PECOS PAC ID | 2860563426 |
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Medicare Enrollment ID | O20080625000485 |
Identifier | Type | State | Issuer |
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1154582005 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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2084N0400X | Psychiatry & Neurology - Neurology | 122304 (New York) | Primary |
Provider Name | Suresh V Undavia |
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Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1386627065 PECOS PAC ID: 1951472505 Enrollment ID: I20080625000476 |
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