Provider Demographics
NPI:1043375314
Name:AKKAPEDDI, SUDHA LAKSHMI (MD)
Entity Type:Individual
Prefix:DR
First Name:SUDHA
Middle Name:LAKSHMI
Last Name:AKKAPEDDI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:9 PRIVATE LOVETT CT
Mailing Address - Street 2:
Mailing Address - City:BLAUVELT
Mailing Address - State:NY
Mailing Address - Zip Code:10913-1247
Mailing Address - Country:US
Mailing Address - Phone:845-398-1711
Mailing Address - Fax:845-942-8623
Practice Address - Street 1:2016 BRONXDALE AVE
Practice Address - Street 2:SUITE 101
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10462-3388
Practice Address - Country:US
Practice Address - Phone:718-918-1102
Practice Address - Fax:718-918-9756
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-27
Last Update Date:2015-03-18
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY2056292081P2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01896859Medicaid
NY01896859Medicaid
NY22Z231Medicare UPIN