Provider Demographics
NPI:1609942986
Name:HANSRAJ, KENNETH KARAMCHAND (MD)
Entity Type:Individual
Prefix:DR
First Name:KENNETH
Middle Name:KARAMCHAND
Last Name:HANSRAJ
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 1:243 NORTH ROAD
Mailing Address - Street 2:SUITE 202S
Mailing Address - City:POUGHKEEPSIE
Mailing Address - State:NY
Mailing Address - Zip Code:12601
Mailing Address - Country:US
Mailing Address - Phone:845-471-9200
Mailing Address - Fax:845-471-1551
Practice Address - Street 1:243 NORTH ROAD
Practice Address - Street 2:SUITE 202S
Practice Address - City:POUGHKEEPSIE
Practice Address - State:NY
Practice Address - Zip Code:12601
Practice Address - Country:US
Practice Address - Phone:845-471-9200
Practice Address - Fax:845-471-1551
Is Sole Proprietor?:No
Enumeration Date:2006-11-28
Last Update Date:2024-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2021110207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01840440Medicaid
610325500OtherOWCP DEPT OF LABOR
NY960523OtherMVP
NYP00234296OtherMEDICARE RAILROAD
NY10047504OtherCDPHP