Provider Demographics
NPI:1811494628
Name:UDOYEN HEALTH LLC
Entity type:Organization
Organization Name:UDOYEN HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:
Authorized Official - First Name:UBONG
Authorized Official - Middle Name:J
Authorized Official - Last Name:UDOYEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:203-414-1801
Mailing Address - Street 1:1414 W PARK PL
Mailing Address - Street 2:SUITE 202
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53224
Mailing Address - Country:US
Mailing Address - Phone:203-414-1801
Mailing Address - Fax:
Practice Address - Street 1:1414 W PARK PL
Practice Address - Street 2:SUITE 202
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53224
Practice Address - Country:US
Practice Address - Phone:203-414-1801
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-04-09
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty