Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RX0202X | Medical Oncology | 240693 | NY |
NPI | 1003910209 |
---|---|
Provider Name | Dr. Andrzej Kudelka |
First Address | Stony Brook, NY 11794-8151 |
Second Address | Stony Brook, NY 11794-8151 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/09/2006 |
Last Update Date | 05/06/2013 |