Provider Demographics
NPI:1124350848
Name:BANERJEE, KRISHNA (MD, MRCP, FRCPCH)
Entity type:Individual
Prefix:DR
First Name:KRISHNA
Middle Name:
Last Name:BANERJEE
Suffix:
Gender:F
Credentials:MD, MRCP, FRCPCH
Other - Prefix:DR
Other - First Name:KRISHNA
Other - Middle Name:
Other - Last Name:BANDYOPADHYAY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:800 WASHINGTON ST
Mailing Address - Street 2:#334
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02111-1552
Mailing Address - Country:US
Mailing Address - Phone:617-636-7242
Mailing Address - Fax:617-636-5621
Practice Address - Street 1:800 WASHINGTON ST
Practice Address - Street 2:#334
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02111-1552
Practice Address - Country:US
Practice Address - Phone:617-636-7242
Practice Address - Fax:617-636-5621
Is Sole Proprietor?:No
Enumeration Date:2010-02-04
Last Update Date:2010-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2432882080P0006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0006XAllopathic & Osteopathic PhysiciansPediatricsDevelopmental - Behavioral Pediatrics