Healthcare Provider Details

I. General information

NPI: 1467524041
Provider Name (Legal Business Name): KALPANA RASHMIN MASTER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KALPANA MADHUSUDAN BHATT MD

II. Dates (important events)

Enumeration Date: 11/15/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8823 JUSTICE AVENUE KALPANA MASTER MD FAAP
ELMHURST NY
11373-4558
US

IV. Provider business mailing address

8823 JUSTICE AVENUE KALPANA MASTER MD FAAP
ELMHURST NY
11373-4558
US

V. Phone/Fax

Practice location:
  • Phone: 718-271-0110
  • Fax: 718-592-6340
Mailing address:
  • Phone: 718-271-0110
  • Fax: 718-592-6340

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number1668501
License Number StateNY

VII. Legacy identifiers

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

# 1
Identifier00989299
Identifier TypeMEDICAID
Identifier StateNY
Identifier Issuer

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: