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General NPI Number Information
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NPI Number | 1396112298
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Entity Type | Organization
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Legal Business Name | BLUE MEDICAL SERVICES, P.C.
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Dates
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Enumeration Date | 08/26/2015
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Last Update Date | 08/26/2015
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Provider Practice Location Address
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Address Line | 437 W 125TH ST
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City | NEW YORK
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State | NY
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Zip | 10027-4201
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Country | US
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Telephone | 646-707-3930
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Fax | 646-837-0510
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Provider Business Mailing Address
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Address Line | 437 W 125TH ST
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City | NEW YORK
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State | NY
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Zip | 10027-4201
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Country | US
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Telephone | 646-707-3930
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Fax | 646-837-0510
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. KARTHIK KARIBANDI
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Credential | M.D.
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Telephone | 646-707-3930
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 272095
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License Number State | NY
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