Healthcare Provider Details

I. General information

NPI: 1912334103
Provider Name (Legal Business Name): KRS MEDICAL SERVICES, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/02/2013
Last Update Date: 10/02/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

322 LINDEN BLVD
BROOKLYN NY
11226-3579
US

IV. Provider business mailing address

PO BOX 180
ALBERTSON NY
11507-0180
US

V. Phone/Fax

Practice location:
  • Phone: 718-237-1596
  • Fax: 718-222-1650
Mailing address:
  • Phone: 718-237-1596
  • Fax: 718-222-1650

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QE0800X
TaxonomyEndoscopy Clinic/Center
License Number189588
License Number StateNY

VIII. Authorized Official

Name: DR. PURNA CHANDRA PRASAD ATLURI
Title or Position: OWNER
Credential: M.D.
Phone: 718-237-1596