MEDICARE: DR. PREETI KISHORE MD

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	207RE0101X	Endocrinology, Diabetes & Metabolism Physician	223965	NY

General Provider Information

NPI Number	:	1477634806
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PREETI KISHORE MD

Provider Business Mailing Address
First Line	:	2700 WESTCHESTER AVE
Second Line	:
City	:	PURCHASE
State	:	NY
Zip	:	10577-2547
Country	:	US
Telephone Number	:	914-682-6538
Fax Number	:	914-457-1583

Provider Business Practice Location Address
First Line	:	73 MARKET ST
Second Line	:
City	:	YONKERS
State	:	NY
Zip	:	10710-7602
Country	:	US
Telephone Number	:	914-831-4150
Fax Number	:	914-831-4151

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

Provider Enumeration Date	:	10/19/2006
Last Update Date	:	11/18/2013

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