Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0129X | Vascular Surgeon | 121593 | NY |
NPI | 1174526925 |
---|---|
Provider Name | Dr. Akula V Krishna |
First Address | Schenectady, NY 12308-2589 |
Second Address | Schenectady, NY 12308-2589 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/05/2005 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00531966 | (05) | NY |
B80723 | (02) | NY |