Provider Demographics
NPI:1740375989
Name:SESHADRI, KAPILA (MD)
Entity type:Individual
Prefix:
First Name:KAPILA
Middle Name:
Last Name:SESHADRI
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 1:8906 135TH ST STE 7L
Mailing Address - Street 2:
Mailing Address - City:JAMAICA
Mailing Address - State:NY
Mailing Address - Zip Code:11418-2828
Mailing Address - Country:US
Mailing Address - Phone:718-670-5213
Mailing Address - Fax:718-321-6004
Practice Address - Street 1:4359 147TH ST
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11355-1741
Practice Address - Country:US
Practice Address - Phone:718-670-5213
Practice Address - Fax:718-321-6004
Is Sole Proprietor?:No
Enumeration Date:2006-10-04
Last Update Date:2025-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY180045-12080P0006X
NJMA454222080P0006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0006XAllopathic & Osteopathic PhysiciansPediatricsDevelopmental - Behavioral Pediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1353501Medicaid
NJ565547C73Medicare PIN
NJ1353501Medicaid