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NPI Code Detail

MEDICARE: DR. MADHAVI REDDY KANCHARLA M.D.

MEDICARE:  DR. MADHAVI REDDY KANCHARLA  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 Physician230978NY

General Provider Information

NPI Number : 1073629622
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MADHAVI REDDY KANCHARLA M.D.
Provider Business Mailing Address
First Line : 2649 STRANG BLVD STE 304
Second Line :
City : YORKTOWN HEIGHTS
State : NY
Zip : 10598-2938
Country : US
Telephone Number : 914-739-0087
Fax Number : 914-737-1714
Provider Business Practice Location Address
First Line : 3379 CROMPOND RD
Second Line :
City : YORKTOWN HEIGHTS
State : NY
Zip : 10598-3605
Country : US
Telephone Number : 914-849-7060
Fax Number : 914-848-7062
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/23/2006
Last Update Date : 02/07/2023

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