Provider Demographics
NPI:1497740609
Name:KRISHNAMURTI, UMA (MD)
Entity Type:Individual
Prefix:DR
First Name:UMA
Middle Name:
Last Name:KRISHNAMURTI
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 1:310 CEDAR ST
Mailing Address - Street 2:
Mailing Address - City:NEW HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06510-3218
Mailing Address - Country:US
Mailing Address - Phone:203-785-3624
Mailing Address - Fax:203-785-7037
Practice Address - Street 1:BRADY MEMORIAL LABORATORY
Practice Address - Street 2:310 CEDAR STREET
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06520
Practice Address - Country:US
Practice Address - Phone:203-785-3624
Practice Address - Fax:203-785-7037
Is Sole Proprietor?:No
Enumeration Date:2005-09-14
Last Update Date:2021-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT68993207ZP0102X
PAMD420755207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV3810001972Medicaid
PA1011068110001Medicaid
OH2554936Medicaid
PA083711NHCMedicare PIN
OH2554936Medicaid
PAP00160478Medicare PIN