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NPI Code Detail

MEDICARE: PRABHAKAR KOCHERLAKOTA MD

MEDICARE: PRABHAKAR KOCHERLAKOTA MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12080N0001XNeonatal-Perinatal Medicine Physician240081NY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1326035031
Entity Type Code : Individual
Provider Name (Legal Business Name) : PRABHAKAR KOCHERLAKOTA MD
Provider Business Mailing Address
First Line : 22 SAW MILL RIVER RD
Second Line : 2ND FLOOR
City : HAWTHORNE
State : NY
Zip : 10532-1533
Country : US
Telephone Number : 914-593-1606
Fax Number : 914-593-1790
Provider Business Practice Location Address
First Line : 70 DUBOIS ST
Second Line :
City : NEWBURGH
State : NY
Zip : 12550-4851
Country : US
Telephone Number : 914-493-8558
Fax Number : 914-493-1488
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/29/2005
Last Update Date : 07/15/2015

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Directions to “ PRABHAKAR KOCHERLAKOTA MD” Practice Location

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