Basic Information
| Provider Information | |||||||||
| NPI: | 1437461282 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | KADIYALA | ||||||||
| FirstName: | ARAVIND BABU | ||||||||
| MiddleName: | |||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4422 3RD AVE | ||||||||
| Address2: | |||||||||
| City: | BRONX | ||||||||
| State: | NY | ||||||||
| PostalCode: | 104572545 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7189606202 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 4422 3RD AVE | ||||||||
| Address2: | |||||||||
| City: | BRONX | ||||||||
| State: | NY | ||||||||
| PostalCode: | 104572545 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7189606202 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/09/2010 | ||||||||
| LastUpdateDate: | 08/20/2019 | ||||||||
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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 | 207R00000X | ME115853 | FL | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.