Provider Demographics
NPI:1285976126
Name:NARENDRA A KUMTHEKAR PHYSICIAN PC
Entity type:Organization
Organization Name:NARENDRA A KUMTHEKAR PHYSICIAN PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:NARENDRA
Authorized Official - Middle Name:A
Authorized Official - Last Name:KUMTHEKAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:914-843-8996
Mailing Address - Street 1:PO BOX 429
Mailing Address - Street 2:
Mailing Address - City:HARRISON
Mailing Address - State:NY
Mailing Address - Zip Code:10528-0429
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1700 FLATBUSH AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11210-3943
Practice Address - Country:US
Practice Address - Phone:914-843-8996
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-18
Last Update Date:2013-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY224765208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY07084GOtherMEDICARE ID GHI
NY02299567Medicaid
NY1172H1OtherMEDICARE ID
NY07084GOtherMEDICARE ID GHI
Y33938Medicare UPIN