Provider Demographics
NPI:1942382213
Name:PADI, MADHU H (MD)
Entity Type:Individual
Prefix:
First Name:MADHU
Middle Name:H
Last Name:PADI
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 1:150 BROADWAY
Mailing Address - Street 2:STE 302A
Mailing Address - City:MENANDS
Mailing Address - State:NY
Mailing Address - Zip Code:12204-2732
Mailing Address - Country:US
Mailing Address - Phone:518-433-1936
Mailing Address - Fax:518-433-1937
Practice Address - Street 1:150 BROADWAY
Practice Address - Street 2:STE 302A
Practice Address - City:MENANDS
Practice Address - State:NY
Practice Address - Zip Code:12204-2732
Practice Address - Country:US
Practice Address - Phone:518-433-1936
Practice Address - Fax:518-433-1937
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-19
Last Update Date:2022-03-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY1721812084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01699994Medicaid
J300000083Medicare PIN
E47194Medicare UPIN
A300000854Medicare PIN