Provider Demographics
NPI:1285629626
Name:KUNDU, SUBHENDU (MD)
Entity Type:Individual
Prefix:DR
First Name:SUBHENDU
Middle Name:
Last Name:KUNDU
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8132 256TH ST
Mailing Address - Street 2:
Mailing Address - City:GLEN OAKS
Mailing Address - State:NY
Mailing Address - Zip Code:11004-1416
Mailing Address - Country:US
Mailing Address - Phone:718-343-3401
Mailing Address - Fax:718-347-0230
Practice Address - Street 1:1401 NEWKIRK AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11226-6521
Practice Address - Country:US
Practice Address - Phone:718-283-1600
Practice Address - Fax:718-635-6020
Is Sole Proprietor?:No
Enumeration Date:2005-09-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY209274207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01886002Medicaid
NY01886002Medicaid