Provider Demographics
NPI:1780734194
Name:NIBHANIPUDI, KUMARA V (MD)
Entity type:Individual
Prefix:DR
First Name:KUMARA
Middle Name:V
Last Name:NIBHANIPUDI
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 1:6 CHERRY LN
Mailing Address - Street 2:
Mailing Address - City:SCARSDALE
Mailing Address - State:NY
Mailing Address - Zip Code:10583-3118
Mailing Address - Country:US
Mailing Address - Phone:914-725-0219
Mailing Address - Fax:
Practice Address - Street 1:1901, FIRST AVE,
Practice Address - Street 2:METROPOLITAN HOSPITAL CENTER,
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10029
Practice Address - Country:US
Practice Address - Phone:212-423-6464
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY142070207PP0204X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207PP0204XAllopathic & Osteopathic PhysiciansEmergency MedicinePediatric Emergency Medicine