Provider Demographics
NPI:1801034350
Name:BUDHU, PRYA M (RN)
Entity type:Individual
Prefix:
First Name:PRYA
Middle Name:M
Last Name:BUDHU
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8656 256TH ST
Mailing Address - Street 2:
Mailing Address - City:FLORAL PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11001
Mailing Address - Country:US
Mailing Address - Phone:718-343-0661
Mailing Address - Fax:
Practice Address - Street 1:825 EAST GATE BLVD.
Practice Address - Street 2:ROOM NUMBER 101B
Practice Address - City:GARDEN CITY
Practice Address - State:NY
Practice Address - Zip Code:11530
Practice Address - Country:US
Practice Address - Phone:516-741-8600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-01-21
Last Update Date:2009-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY490247163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse