Healthcare Provider Details

I. General information

NPI: 1841251139
Provider Name (Legal Business Name): NANDA KERKAR M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/28/2006
Last Update Date: 06/29/2023
Certification Date: 11/19/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 ELMWOOD AVE
ROCHESTER NY
14642-6062
US

IV. Provider business mailing address

601 ELMWOOD AVE BOX 667
ROCHESTER NY
14642-0001
US

V. Phone/Fax

Practice location:
  • Phone: 585-275-2647
  • Fax: 585-275-0707
Mailing address:
  • Phone: 585-275-2647
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code204F00000X
TaxonomyTransplant Surgery Physician
License Number237619
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number237619
License Number StateNY
# 3
Primary TaxonomyN
Taxonomy Code2080P0206X
TaxonomyPediatric Gastroenterology Physician
License Number237619
License Number StateNY
# 4
Primary TaxonomyY
Taxonomy Code2080P0206X
TaxonomyPediatric Gastroenterology Physician
License Number001746
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: