Doctor Name: | DR. KRISTAPPA SANGAVARAM |
NPI Number: | 1376635722 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.D. |
License Number: | 25MA05589800 |
Business Practice Address: | 303 Molnar Drive 1st Floor Elmwood Park, NJ - 07407 |
Business Phone Number: | 2017964007 |
Business Fax Number: | 2017964080 |
Mailing Address: | 303 Molnar Drive, 1st Floor ELMWOOD PARK |
State: | NJ |
Postal Code: | 07407 |
Phone Number: | 2017964007 |
Fax Number: | 2017964080 |
NPI Enumeration Date: | 09/29/2006 |
NPI Last Update Date: | 07/31/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | 25MA05589800 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NJ |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |