Provider Demographics
NPI:1841251139
Name:KERKAR, NANDA (MD)
Entity type:Individual
Prefix:
First Name:NANDA
Middle Name:
Last Name:KERKAR
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 1:601 ELMWOOD AVE BOX 667
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14642-0001
Mailing Address - Country:US
Mailing Address - Phone:585-275-2647
Mailing Address - Fax:
Practice Address - Street 1:601 ELMWOOD AVE
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14642-6062
Practice Address - Country:US
Practice Address - Phone:585-275-2647
Practice Address - Fax:585-275-0707
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-28
Last Update Date:2023-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY237619204F00000X, 208000000X, 2080P0206X
NY0017462080P0206X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0206XAllopathic & Osteopathic PhysiciansPediatricsPediatric Gastroenterology
No204F00000XAllopathic & Osteopathic PhysiciansTransplant Surgery
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02363766Medicaid
NY672Z31OtherBLUE CROSS BLUE SHIELD
NY8R765WR701Medicare PIN