Provider Demographics
NPI:1043263882
Name:UDAY, KALPANA A (MD)
Entity Type:Individual
Prefix:
First Name:KALPANA
Middle Name:A
Last Name:UDAY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17 BECKETT CLOSE
Mailing Address - Street 2:
Mailing Address - City:IRVINGTON
Mailing Address - State:NY
Mailing Address - Zip Code:10533-2413
Mailing Address - Country:US
Mailing Address - Phone:718-518-5232
Mailing Address - Fax:718-518-5636
Practice Address - Street 1:1650 GRAND CONCOURSE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10457-7606
Practice Address - Country:US
Practice Address - Phone:718-518-5232
Practice Address - Fax:718-518-5636
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-19
Last Update Date:2011-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY178765207R00000X, 207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01404737Medicaid
F49400Medicare UPIN
NY01404737Medicaid