Healthcare Provider Details

I. General information

NPI: 1649200635
Provider Name (Legal Business Name): V. KRISHNAN NAIR M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/04/2006
Last Update Date: 10/19/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

126 E CHURCH ST SUITE 2400
SOMERSET PA
15501-2271
US

IV. Provider business mailing address

126 E CHURCH ST SUITE 2400
SOMERSET PA
15501-2271
US

V. Phone/Fax

Practice location:
  • Phone: 814-445-7101
  • Fax: 814-445-7688
Mailing address:
  • Phone: 814-445-7101
  • Fax: 814-445-7688

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberMD024353E
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: