Individual ProviderSudha GuttikondaStudent in an Organized Health Care Education/Training ProgramStudent, Health CarePractice Address1051 Riverside Dr, New York, NY 10032-1007(646) 774-6300PECOS EnrollmentBased on the most recent information from CMS, provider Sudha Guttikonda does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 10:51 AM.Profile DetailsProvider ID1538803994Provider TypeIndividualFull NameGuttikonda, SudhaTitleDr.CredentialMD, PHDGenderFemaleSole ProprietorNoEnumeration Date4/22/2022Last Updated4/22/2022Contact InformationPractice LocationPractice Address1051 Riverside Dr, New York, NY 10032-1007Phone(646) 774-6300FaxUnlisted FaxMailing LocationMailing Address1051 Riverside Drive, PO Box 103, New York, NY 10032Phone(646) 774-6300FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode390200000XPrimaryDescriptionStudent in an Organized Health Care Education/Training ProgramStudent, Health CareLicenseUnlisted Issuer