Provider Demographics
NPI:1669532933
Name:KAKKANATT, ANAND EMMANUEL (MD)
Entity type:Individual
Prefix:DR
First Name:ANAND
Middle Name:EMMANUEL
Last Name:KAKKANATT
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 1:320 ROBINSON AVE
Mailing Address - Street 2:
Mailing Address - City:NEWBURGH
Mailing Address - State:NY
Mailing Address - Zip Code:12550-3353
Mailing Address - Country:US
Mailing Address - Phone:845-565-1989
Mailing Address - Fax:845-863-0072
Practice Address - Street 1:320 ROBINSON AVE
Practice Address - Street 2:
Practice Address - City:NEWBURGH
Practice Address - State:NY
Practice Address - Zip Code:12550-3353
Practice Address - Country:US
Practice Address - Phone:845-565-1989
Practice Address - Fax:845-863-0072
Is Sole Proprietor?:No
Enumeration Date:2006-12-09
Last Update Date:2010-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2399002085R0202X, 2085N0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
No2085N0700XAllopathic & Osteopathic PhysiciansRadiologyNeuroradiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYP00607230OtherRAILROAD MEDICARE
NY02846091Medicaid
NY916T522871Medicare PIN
NY916T511821Medicare PIN
NY916T511822Medicare PIN
NY916T508571Medicare PIN
NYP00607230OtherRAILROAD MEDICARE
NY916T521711Medicare PIN
NY916T508572Medicare PIN
NY916T521361Medicare PIN
NY916T5X0651Medicare PIN