MEDICARE: LAKSHMI T. PARUCHURI 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
1	207R00000X	Internal Medicine Physician	207157	NY

Other Identifiers

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

General Provider Information

NPI Number	:	1396829115
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAKSHMI T. PARUCHURI M.D.

Provider Business Mailing Address
First Line	:	10 VENEZIA DR
Second Line	:
City	:	MONROE TWP
State	:	NJ
Zip	:	08831-8673
Country	:	US
Telephone Number	:	732-251-2569
Fax Number	:

Provider Business Practice Location Address
First Line	:	1400 PELHAM PKWY S
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10461-1138
Country	:	US
Telephone Number	:	718-918-6027
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/25/2006
Last Update Date	:	07/08/2007

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