Provider Demographics
NPI:1083690374
Name:KRISHNAMURTHY, USHA (MD)
Entity Type:Individual
Prefix:DR
First Name:USHA
Middle Name:
Last Name:KRISHNAMURTHY
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 1:5516 MAIN ST
Mailing Address - Street 2:SUITE 1B
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11355-5098
Mailing Address - Country:US
Mailing Address - Phone:718-461-0017
Mailing Address - Fax:718-461-0018
Practice Address - Street 1:5516 MAIN ST
Practice Address - Street 2:SUITE 1B
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11355-5098
Practice Address - Country:US
Practice Address - Phone:718-461-0017
Practice Address - Fax:718-461-0018
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY152595207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYG82133Medicare UPIN