Provider Demographics
NPI:1467745869
Name:BADIPATLA, KANTHI REKHA (MD)
Entity type:Individual
Prefix:DR
First Name:KANTHI REKHA
Middle Name:
Last Name:BADIPATLA
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 1:1650 SELWYN AVE
Mailing Address - Street 2:APARTMENT 15 E
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10457-7626
Mailing Address - Country:US
Mailing Address - Phone:718-715-5553
Mailing Address - Fax:
Practice Address - Street 1:2415 MUSGROVE RD STE 109
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20904-5221
Practice Address - Country:US
Practice Address - Phone:301-838-4244
Practice Address - Fax:301-838-4244
Is Sole Proprietor?:No
Enumeration Date:2011-05-18
Last Update Date:2024-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY291758207R00000X, 207RG0100X
MDD0101878207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine