Basic Information
| Provider Information | |||||||||
| NPI: | 1043635428 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | KAPAVARAPU | ||||||||
| FirstName: | PRASANNA | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2185 HONE AVE | ||||||||
| Address2: | APT 1B | ||||||||
| City: | BRONX | ||||||||
| State: | NY | ||||||||
| PostalCode: | 104611239 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4042025325 | ||||||||
| FaxNumber: | 2129394022 | ||||||||
| Practice Location | |||||||||
| Address1: | 506 LENOX AVE | ||||||||
| Address2: | MLK 17-110 | ||||||||
| City: | NEW YORK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 100371802 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2129394019 | ||||||||
| FaxNumber: | 2129394022 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/21/2014 | ||||||||
| LastUpdateDate: | 02/21/2014 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 282NR1301X | Y | Hospitals | General Acute Care Hospital | Rural |
No ID Information.