Suresh Undavia, MD PLLC

Primary specialty

Neurology PhysicianTaxonomy code 2084N0400X

License

122304 Issued in NY

Legal business name

SURESH UNDAVIA, MD PLLC

Practice address

114 Clayton Ave
Vestal, NY 13850-2430

Phone

(607) 785-4277

Fax

(607) 785-3617

NPI assigned

Jun 23, 2008

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Suresh Undavia, MD PLLC

Title

Psychiatrist

Phone

(607) 785-4277

Specialties & licenses 1

Addresses

Other names 1

• Suresh Undavia, MD PLLC Doing business as

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1214179200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214179200000",
    "number": "1154582005",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 645",
            "city": "VESTAL",
            "state": "NY",
            "postal_code": "138510645",
            "telephone_number": "607-785-4277"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "114 CLAYTON AVE",
            "city": "VESTAL",
            "state": "NY",
            "postal_code": "138502430",
            "telephone_number": "607-785-4277",
            "fax_number": "607-785-3617"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SURESH UNDAVIA, MD PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-23",
        "last_updated": "2008-06-23",
        "status": "A",
        "authorized_official_last_name": "UNDAVIA",
        "authorized_official_first_name": "SURESH",
        "authorized_official_title_or_position": "PSYCHIATRIST",
        "authorized_official_telephone_number": "607-785-4277",
        "authorized_official_credential": "MD PLLC"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "NY",
            "license": "122304",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Suresh Undavia, MD PLLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Neurology Physician in Vestal, NY
• Providers in Vestal, NY by specialty
• Neurology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.