Healthcare Provider Details

I. General information

NPI: 1982940888
Provider Name (Legal Business Name): TRIPALI KUNDU MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/20/2012
Last Update Date: 10/26/2021
Certification Date: 10/20/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

27005 76TH AVE DEPT OF
NEW HYDE PARK NY
11040-1402
US

IV. Provider business mailing address

14222 BOOTH MEMORIAL AVE
FLUSHING NY
11355-5342
US

V. Phone/Fax

Practice location:
  • Phone: 718-470-7390
  • Fax:
Mailing address:
  • Phone: 201-421-0152
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberMD210001663
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: