Provider Demographics
NPI:1912334103
Name:KRS MEDICAL SERVICES, PLLC
Entity Type:Organization
Organization Name:KRS MEDICAL SERVICES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PURNA
Authorized Official - Middle Name:CHANDRA PRASAD
Authorized Official - Last Name:ATLURI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-237-1596
Mailing Address - Street 1:PO BOX 180
Mailing Address - Street 2:
Mailing Address - City:ALBERTSON
Mailing Address - State:NY
Mailing Address - Zip Code:11507-0180
Mailing Address - Country:US
Mailing Address - Phone:718-237-1596
Mailing Address - Fax:718-222-1650
Practice Address - Street 1:322 LINDEN BLVD
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11226-3579
Practice Address - Country:US
Practice Address - Phone:718-237-1596
Practice Address - Fax:718-222-1650
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-02
Last Update Date:2013-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY189588261QE0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QE0800XAmbulatory Health Care FacilitiesClinic/CenterEndoscopy