Provider Demographics
NPI:1801098033
Name:BOODOOSINGH, DEV RICHARD (MD)
Entity type:Individual
Prefix:
First Name:DEV
Middle Name:RICHARD
Last Name:BOODOOSINGH
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:HC 4 BOX 12052
Mailing Address - Street 2:
Mailing Address - City:YAUCO
Mailing Address - State:PR
Mailing Address - Zip Code:00698-9610
Mailing Address - Country:US
Mailing Address - Phone:787-856-2156
Mailing Address - Fax:
Practice Address - Street 1:TORRE SAN LUCAS SUITE 701
Practice Address - Street 2:TITO CASTRO AVE.
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00780
Practice Address - Country:US
Practice Address - Phone:787-840-8899
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-01
Last Update Date:2013-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR26170-R207R00000X
PR17668207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine