Provider Demographics
NPI:1558604710
Name:KABRA, NITIN (MD)
Entity Type:Individual
Prefix:
First Name:NITIN
Middle Name:
Last Name:KABRA
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 1:100 WOODS ROAD
Mailing Address - Street 2:MACY PAVILION, SUITE 100
Mailing Address - City:VALHALLA
Mailing Address - State:NY
Mailing Address - Zip Code:10595
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6601 PRESTON RD
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75024-2502
Practice Address - Country:US
Practice Address - Phone:469-800-6300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-04-05
Last Update Date:2021-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
TXT1976207RA0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RA0001XAllopathic & Osteopathic PhysiciansInternal MedicineAdvanced Heart Failure and Transplant Cardiology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program