Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207PP0204X | Pediatric Emergency Physician | 142070 | NY |
NPI | 1780734194 |
---|---|
Provider Name | Dr. Kumara V Nibhanipudi |
First Address | Scarsdale, NY 10583-3118 |
Second Address | New York, NY 10029 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/01/2007 |
Last Update Date | 08/07/2007 |