Provider Demographics
NPI:1689798464
Name:CHERUKU, ANUPAMA (MD,)
Entity Type:Individual
Prefix:DR
First Name:ANUPAMA
Middle Name:
Last Name:CHERUKU
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 1:8712 58TH AVE
Mailing Address - Street 2:
Mailing Address - City:ELMHURST
Mailing Address - State:NY
Mailing Address - Zip Code:11373-4821
Mailing Address - Country:US
Mailing Address - Phone:718-426-4800
Mailing Address - Fax:718-651-9284
Practice Address - Street 1:8712 58TH AVE
Practice Address - Street 2:
Practice Address - City:ELMHURST
Practice Address - State:NY
Practice Address - Zip Code:11373-4821
Practice Address - Country:US
Practice Address - Phone:718-426-4800
Practice Address - Fax:718-651-9284
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY242958207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine