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NPI Code Detail

MEDICARE: DR. VIVEKANAND KALANADHABHATTA M.D.

MEDICARE: DR. VIVEKANAND KALANADHABHATTA 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
1207K00000XAllergy & Immunology Physician182717NY
2207R00000XInternal Medicine Physician182717NY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1295793263
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. VIVEKANAND KALANADHABHATTA M.D.
Provider Business Mailing Address
First Line : PO BOX 1050
Second Line :
City : NEW HYDE PARK
State : NY
Zip : 11040-0322
Country : US
Telephone Number : 516-761-7636
Fax Number : 718-756-0545
Provider Business Practice Location Address
First Line : 443 LINDEN BLVD
Second Line :
City : BROOKLYN
State : NY
Zip : 11203-2821
Country : US
Telephone Number : 718-736-3591
Fax Number : 845-252-9935
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/01/2006
Last Update Date : 09/26/2014

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