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General NPI Number Information
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NPI Number | 1912956889
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Entity Type | Individual
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Provider Name | JANAKI KANUMILLI MD
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Gender | Female
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Dates
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Enumeration Date | 05/09/2006
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Last Update Date | 04/26/2016
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Provider Practice Location Address
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Address Line | 8338 LITTLE NECK PKWY
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City | FLORAL PARK
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State | NY
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Zip | 11004-1626
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Country | US
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Telephone | 718-347-0504
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Fax | 718-343-3979
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Provider Business Mailing Address
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Address Line | 11050 71ST RD SUITE 1B
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City | FOREST HILLS
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State | NY
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Zip | 11375-4969
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Country | US
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Telephone | 718-263-5909
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Fax | 718-343-3979
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207QA0505X
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Taxonomy Name | Adult Medicine Physician
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License Number | 222149
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License Number State | NY
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