Provider Demographics
NPI:1154205680
Name:SUBEDI, YADU NANDA
Entity type:Individual
Prefix:
First Name:YADU
Middle Name:NANDA
Last Name:SUBEDI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5804 STONE GATE HTS APT 2
Mailing Address - Street 2:
Mailing Address - City:JAMESVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:13078-4507
Mailing Address - Country:US
Mailing Address - Phone:901-340-2943
Mailing Address - Fax:
Practice Address - Street 1:936 WOODYCREST AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10452-5503
Practice Address - Country:US
Practice Address - Phone:718-414-1750
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-05
Last Update Date:2025-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYP137465207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine