Provider Demographics
NPI:1942324132
Name:LAKSHMI, KAMESWARI DESIRAJU (MD)
Entity Type:Individual
Prefix:DR
First Name:KAMESWARI
Middle Name:DESIRAJU
Last Name:LAKSHMI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:175 MEMORIAL HWY STE LL2
Mailing Address - Street 2:
Mailing Address - City:NEW ROCHELLE
Mailing Address - State:NY
Mailing Address - Zip Code:10801-5642
Mailing Address - Country:US
Mailing Address - Phone:914-365-1616
Mailing Address - Fax:914-233-3514
Practice Address - Street 1:175 MEMORIAL HWY STE LL2
Practice Address - Street 2:
Practice Address - City:NEW ROCHELLE
Practice Address - State:NY
Practice Address - Zip Code:10801-5642
Practice Address - Country:US
Practice Address - Phone:914-365-1616
Practice Address - Fax:914-233-3514
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-16
Last Update Date:2022-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY230274207RN0300X, 207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY1942324132Medicaid