Healthcare Provider Details

I. General information

NPI: 1649060500
Provider Name (Legal Business Name): KSR CONSULTING SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/12/2025
Last Update Date: 07/07/2025
Certification Date: 07/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

123 CLARENDON PL
HACKENSACK NJ
07601-3626
US

IV. Provider business mailing address

123 CLARENDON PL
HACKENSACK NJ
07601-3626
US

V. Phone/Fax

Practice location:
  • Phone: 551-301-0310
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: SIVA RAM KORAKUTTY
Title or Position: MANAGER
Credential:
Phone: 626-621-7381