Healthcare Provider Details

I. General information

NPI: 1396087102
Provider Name (Legal Business Name): MEERA KAUSTUBH KIRPEKAR M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/19/2013
Last Update Date: 09/06/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

240 E 38TH ST
NEW YORK NY
10016
US

IV. Provider business mailing address

6060 FAIRMONT PKWY APT# 8208
PASADENA TX
77505-4049
US

V. Phone/Fax

Practice location:
  • Phone: 212-201-1004
  • Fax:
Mailing address:
  • Phone: 713-307-5474
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number292613
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: