Provider Demographics
NPI:1962823419
Name:DURGUDE, YUWRAJH
Entity Type:Individual
Prefix:
First Name:YUWRAJH
Middle Name:
Last Name:DURGUDE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:378 BALTIC ST
Mailing Address - Street 2:APT 6B
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11201-6593
Mailing Address - Country:US
Mailing Address - Phone:917-864-6478
Mailing Address - Fax:
Practice Address - Street 1:378 BALTIC ST
Practice Address - Street 2:APT 6B
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11201-6593
Practice Address - Country:US
Practice Address - Phone:917-864-6478
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-01
Last Update Date:2014-01-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY023277235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist