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NPI Code Detail

MEDICARE: DR. TINA KRISHNARAO

MEDICARE: DR. TINA KRISHNARAO
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
12084F0202XForensic Psychiatry Physician305428NY

General Provider Information

NPI Number : 1689022105
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. TINA KRISHNARAO
Provider Business Mailing Address
First Line : 102 RIVERS EDGE RD
Second Line :
City : NEW YORK
State : NY
Zip : 10035-1163
Country : US
Telephone Number : 646-672-6767
Fax Number :
Provider Business Practice Location Address
First Line : 102 RIVERS EDGE RD
Second Line :
City : NEW YORK
State : NY
Zip : 10035-1163
Country : US
Telephone Number : 646-672-6767
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/25/2016
Last Update Date : 01/18/2024

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