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General NPI Number Information
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NPI Number | 1205372877
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Entity Type | Organization
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Legal Business Name | KRISNIR CORPORATION
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Dates
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Enumeration Date | 01/06/2017
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Last Update Date | 01/06/2017
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Provider Practice Location Address
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Address Line | 1805 HERRINGTON RD BLDG# 2
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City | LAWRENCEVILLE
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State | GA
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Zip | 30043-7987
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Country | US
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Telephone | 770-822-4410
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Fax |
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Provider Business Mailing Address
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Address Line | 3215 SUGARLOAF CLUB DR
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City | DULUTH
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State | GA
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Zip | 30097-3709
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Country | US
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Telephone | 770-822-4410
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | AMITA S PARIKH
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Credential | MD
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Telephone | 770-822-4410
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 44565
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License Number State | GA
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