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NPI Code Detail

MEDICARE: SHYLASREE KRISHNAN M.D.

MEDICARE: SHYLASREE KRISHNAN M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207R00000XInternal Medicine Physician214408NY

General Provider Information

NPI Number : 1023048543
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHYLASREE KRISHNAN M.D.
Provider Business Mailing Address
First Line : 2400 S CLINTON AVE STE G2
Second Line :
City : ROCHESTER
State : NY
Zip : 14618-2636
Country : US
Telephone Number : 585-341-7685
Fax Number :
Provider Business Practice Location Address
First Line : 2400 S CLINTON AVE STE G2
Second Line :
City : ROCHESTER
State : NY
Zip : 14618-2636
Country : US
Telephone Number : 585-341-7685
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/03/2006
Last Update Date : 11/03/2023

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