Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207XX0004X | Foot and Ankle Orthopaedic Surgeon | R-10963 | IA |
Y | 207XX0005X | Sports Medicine Orthopaedic Surgeon | 304050 | NY |
N | 207XX0801X | Orthopaedic Trauma Surgeon | 304050 | NY |
N | 207XX0801X | Orthopaedic Trauma Surgeon | P101696 | NY |
NPI | 1508307737 |
---|---|
Provider Name | Dr. Karthikeyan Chinnakkannu |
First Address | Bronx, NY 10457-7703 |
Second Address | Bronx, NY 10457-7606 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/03/2017 |
Last Update Date | 22/12/2021 |