NPI Code Detail JSON Logo

1639313745 NPI number — TARA KRISHNASASTRY P.A.

NPI Number: 1639313745
Health Care Provider/Practitioner: TARA KRISHNASASTRY P.A.

Information about “1639313745” NPI (TARA KRISHNASASTRY P.A.) exists in 1639313745 in HTML format HTML  |  1639313745 in plain Text format TXT  |  1639313745 in PDF (Portable Document Format) PDF  |  1639313745 in an XML format XML  formats.

NPI Number : 1639313745 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1639313745",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "KRISHNASASTRY",
    "FirstName": "TARA",
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "P.A.",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "11220 72ND DR APT C02",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "FOREST HILLS",
    "MailingAddressStateName": "NY",
    "MailingAddressPostalCode": "11375-5649",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "516-232-3455",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "24411 HEALTH CENTER DR STE 680",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "LAGUNA HILLS",
    "PracticeLocationAddressStateName": "CA",
    "PracticeLocationAddressPostalCode": "92653-3692",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "949-268-4568",
    "PracticeLocationAddressFaxNumber": "954-337-0760",
    "EnumerationDate": "04/21/2009",
    "LastUpdateDate": "03/25/2025",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "363A00000X",
          "TaxonomyName": "Physician Assistant",
          "LicenseNumber": "2944",
          "LicenseNumberStateCode": "NH",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "363A00000X",
          "TaxonomyName": "Physician Assistant",
          "LicenseNumber": "PA64005",
          "LicenseNumberStateCode": "CA",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "363A00000X",
          "TaxonomyName": "Physician Assistant",
          "LicenseNumber": "013169",
          "LicenseNumberStateCode": "NY",
          "PrimaryTaxonomySwitch": "Y"
        },
        {
          "TaxonomyCode": "363A00000X",
          "TaxonomyName": "Physician Assistant",
          "LicenseNumber": "5352",
          "LicenseNumberStateCode": "CT",
          "PrimaryTaxonomySwitch": "N"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

Copyright © 2007-2026 Data Labs Health. All rights reserved.