Provider Demographics
NPI:1740216670
Name:KIRPEKAR, MADHURI (MD)
Entity type:Individual
Prefix:
First Name:MADHURI
Middle Name:
Last Name:KIRPEKAR
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 1:1780 BROADWAY
Mailing Address - Street 2:SUITE 1100
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10019
Mailing Address - Country:US
Mailing Address - Phone:212-590-2930
Mailing Address - Fax:212-590-2982
Practice Address - Street 1:1111 AMSTERDAM AVENUE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10025
Practice Address - Country:US
Practice Address - Phone:212-590-2930
Practice Address - Fax:212-590-2982
Is Sole Proprietor?:No
Enumeration Date:2006-06-23
Last Update Date:2011-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1395452085R0205X, 2085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
No2085R0205XAllopathic & Osteopathic PhysiciansRadiologyRadiological Physics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00701079Medicaid
NY69A781Medicare ID - Type Unspecified
NY00701079Medicaid