Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207KA0200X | Allergist | NY111841 | NY |
NPI | 1659469765 |
---|---|
Provider Name | Dr. Kishan Rao Battu |
First Address | Troy, NY 12182-2331 |
Second Address | Troy, NY 12182-2331 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/10/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
DD2969 | (02) | NY |