Provider Demographics
NPI:1790119980
Name:MADHAVARAPU, KRISHNA CHAITANYA (MD)
Entity Type:Individual
Prefix:
First Name:KRISHNA
Middle Name:CHAITANYA
Last Name:MADHAVARAPU
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 1:1111 AMSTERDAM AVE
Mailing Address - Street 2:PLANT BUILDING, GROUND FLOOR, ROOM 2050
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10025-1716
Mailing Address - Country:US
Mailing Address - Phone:408-679-2394
Mailing Address - Fax:
Practice Address - Street 1:1111 AMSTERDAM AVE
Practice Address - Street 2:PLANT BUILDING, GROUND FLOOR, ROOM 2050
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10025-1716
Practice Address - Country:US
Practice Address - Phone:408-679-2394
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-25
Last Update Date:2013-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ZZ56578207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine