Provider Demographics
NPI:1366477184
Name:KATARI, VENKATA (MD)
Entity Type:Individual
Prefix:
First Name:VENKATA
Middle Name:
Last Name:KATARI
Suffix:
Gender:M
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:PO BOX 27391
Mailing Address - Street 2:ANES ASSOC OF MT KISCO
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10087-7391
Mailing Address - Country:US
Mailing Address - Phone:800-720-1664
Mailing Address - Fax:207-753-2020
Practice Address - Street 1:400 E MAIN ST
Practice Address - Street 2:ANES ASSOC OF MT KISCO
Practice Address - City:MOUNT KISCO
Practice Address - State:NY
Practice Address - Zip Code:10549-3417
Practice Address - Country:US
Practice Address - Phone:914-666-4050
Practice Address - Fax:914-666-5012
Is Sole Proprietor?:No
Enumeration Date:2006-07-11
Last Update Date:2007-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY146807207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01123404Medicaid
C10968Medicare UPIN
NY52A321Medicare PIN
NY52A321Medicare ID - Type Unspecified