Provider Demographics
NPI:1326690926
Name:KAKUMANI, VENKATA KIRANMAYI (MD)
Entity Type:Individual
Prefix:
First Name:VENKATA KIRANMAYI
Middle Name:
Last Name:KAKUMANI
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:BETH ISRAEL DEACONESS MEDICAL CENTER- MILTON
Mailing Address - Street 2:199 REEDSDALE RD
Mailing Address - City:MILTON
Mailing Address - State:MA
Mailing Address - Zip Code:02186
Mailing Address - Country:US
Mailing Address - Phone:617-313-1377
Mailing Address - Fax:
Practice Address - Street 1:BETH ISRAEL DEACONESS MEDICAL CENTER- MILTON
Practice Address - Street 2:199 REEDSDALE ROAD
Practice Address - City:MILTON
Practice Address - State:MA
Practice Address - Zip Code:02186
Practice Address - Country:US
Practice Address - Phone:617-313-1377
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-12
Last Update Date:2022-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
MA291952208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program