Healthcare Provider Details

I. General information

NPI: 1023589348
Provider Name (Legal Business Name): KANINGHAT PRASANTH PHYSICIAN PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/14/2018
Last Update Date: 08/08/2025
Certification Date: 08/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5707 146TH ST
FLUSHING NY
11355-5322
US

IV. Provider business mailing address

5707 146TH ST
FLUSHING NY
11355-5350
US

V. Phone/Fax

Practice location:
  • Phone: 347-506-1146
  • Fax:
Mailing address:
  • Phone: 929-512-5187
  • Fax: 929-399-2430

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080N0001X
TaxonomyNeonatal-Perinatal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: KANINGHAT PRASANTH
Title or Position: OWNER
Credential: MD
Phone: 929-512-5187