Healthcare Provider Details

I. General information

NPI: 1801565296
Provider Name (Legal Business Name): MADALASA POKHREL
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/08/2021
Last Update Date: 07/27/2026
Certification Date: 07/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16 GUION PL
NEW ROCHELLE NY
10801-5502
US

IV. Provider business mailing address

16 GUION PL
NEW ROCHELLE NY
10801-5502
US

V. Phone/Fax

Practice location:
  • Phone: 914-365-3680
  • Fax: 914-365-5489
Mailing address:
  • Phone: 606-487-7510
  • Fax: 606-439-6793

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License Number61836
License Number StateKY
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number61836
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: