Provider Demographics
NPI:1255498325
Name:KANAPARTHY, KALYANA CHAKRAVARTHY (MD)
Entity type:Individual
Prefix:DR
First Name:KALYANA
Middle Name:CHAKRAVARTHY
Last Name:KANAPARTHY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:KALYANA
Other - Middle Name:
Other - Last Name:KANAPARTHY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:1425 PORTLAND AVE # 242
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14621-3001
Mailing Address - Country:US
Mailing Address - Phone:585-922-5067
Mailing Address - Fax:
Practice Address - Street 1:1425 PORTLAND AVENUE
Practice Address - Street 2:DEPT OF MEDICINE, BOX 242
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14621-3001
Practice Address - Country:US
Practice Address - Phone:585-922-5067
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-02
Last Update Date:2022-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY273050208M00000X
NY002886208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02896899Medicaid
NY02896899Medicaid
NY10712AMedicare PIN
NY70005AMedicare PIN
NYRB7375Medicare PIN