Healthcare Provider Details

I. General information

NPI: 1770891665
Provider Name (Legal Business Name): KANINGHAT PRASANTH MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/14/2010
Last Update Date: 05/18/2026
Certification Date: 05/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9010 101ST AVE
OZONE PARK NY
11416-2217
US

IV. Provider business mailing address

9010 101ST AVE
OZONE PARK NY
11416-2217
US

V. Phone/Fax

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

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2080N0001X
TaxonomyNeonatal-Perinatal Medicine Physician
License Number271701
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number271701
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: