Provider Demographics
NPI:1619065430
Name:NEUDACHIN, LUDMILLA (MD)
Entity Type:Individual
Prefix:DR
First Name:LUDMILLA
Middle Name:
Last Name:NEUDACHIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:347 E 37TH ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-3217
Mailing Address - Country:US
Mailing Address - Phone:212-726-7449
Mailing Address - Fax:212-981-7234
Practice Address - Street 1:347 E 37TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-3217
Practice Address - Country:US
Practice Address - Phone:212-726-7449
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-10
Last Update Date:2011-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY173404207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDF25299Medicare UPIN