Legacy Medical Pllc
NPI #1457609653 in Jackson Hts, New York
Provider Information
- NPI Number
- 1457609653
- Entity Type
- Organization
- Organization Name
- Legacy Medical Pllc
- Primary Specialty
- Psychiatry & Neurology - Neurology
- Enumeration Date
- Aug 17, 2012
- Last Updated
- Feb 25, 2020
Practice Location
- Address
- 3741 77TH ST
- City
- Jackson Hts
- State
- New York
- ZIP Code
- 11372-6629
- Phone
- (718) 406-9588
Authorized Official
- Name
- MADHU BOPPANA, M.D,
- Title
- OWNER
- Phone
- (646) 270-1050
Specialties & Taxonomy Codes
| Specialty |
|---|
| Psychiatry & Neurology - Neurology — Neurology |
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