Provider Demographics
NPI:1013374016
Name:SUDHIR GADH, LLC
Entity Type:Organization
Organization Name:SUDHIR GADH, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:SUDHIR
Authorized Official - Middle Name:
Authorized Official - Last Name:GADH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-666-7456
Mailing Address - Street 1:370 E 149TH ST
Mailing Address - Street 2:3RD FLOOR SUITE 8
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10455-3900
Mailing Address - Country:US
Mailing Address - Phone:718-666-7456
Mailing Address - Fax:718-310-3303
Practice Address - Street 1:432 E 149TH ST
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10455-1343
Practice Address - Country:US
Practice Address - Phone:718-673-9337
Practice Address - Fax:718-310-3303
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-21
Last Update Date:2016-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY243760103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty