MEDICARE: DR. RANGA CHELVA KRISHNA 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	2084N0400X	Neurology Physician	194198	NY
2	204D00000X	Neuromusculoskeletal Medicine & OMM Physician	194918	NY

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
4	P00008944	OTHER	NY	RAIL ROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	116750101	OTHER	NY	HEALTH PLUS
2	1730151218	OTHER	NY	VNS OF NY
3	504751	OTHER	NY	EMPIRE HEALTHCHOICE
5	000116750101	OTHER	NY	HEALTH PLUS AMERIGROUP SOLUTION
6	5527395	OTHER	NY	AETNA PPO
7	194198-A21	OTHER	NY	HEALTH FIRST
8	6014163	OTHER	NY	GHI
9	010194198NY01	OTHER	NY	AMERICHOICE
10	100181179001	OTHER	NY	UHC COMMUNITY PLAN
11	P1105203	OTHER	NY	OXFORD
12	31914P	OTHER	NY	HIP
13	000181170	OTHER	NY	UNITED HEALTHCARE
14	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
15	107945000	OTHER		LABOR DEPT.
16	132655001KR01	OTHER	NY	CARE PLUS
17	2144578	OTHER	NY	AETNA HMO

General Provider Information

NPI Number	:	1730151218
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RANGA CHELVA KRISHNA M.D.

Provider Business Mailing Address
First Line	:	1513 VOORHIES AVE
Second Line	:	1ST FLOOR
City	:	BROOKLYN
State	:	NY
Zip	:	11235-3994
Country	:	US
Telephone Number	:	718-332-7878
Fax Number	:	718-332-8051

Provider Business Practice Location Address
First Line	:	1513 VOORHIES AVE
Second Line	:	1ST FLOOR
City	:	BROOKLYN
State	:	NY
Zip	:	11235-3994
Country	:	US
Telephone Number	:	718-332-7878
Fax Number	:	718-332-8051

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

Provider Enumeration Date	:	02/07/2006
Last Update Date	:	09/11/2012

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