Provider Demographics
NPI:1891040911
Name:GUDDATI, HARISH (MD)
Entity Type:Individual
Prefix:DR
First Name:HARISH
Middle Name:
Last Name:GUDDATI
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 1:1470 KNAPP ST
Mailing Address - Street 2:APT 401
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10469-3069
Mailing Address - Country:US
Mailing Address - Phone:347-393-5415
Mailing Address - Fax:
Practice Address - Street 1:600 E 233RD ST
Practice Address - Street 2:MONTEFIORE MEDICAL CENTER NORTH DIVISION
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10466-2604
Practice Address - Country:US
Practice Address - Phone:718-920-9880
Practice Address - Fax:718-920-9036
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-14
Last Update Date:2012-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program