Provider Demographics
NPI:1386714426
Name:VOHRA, KIRAN (MD)
Entity type:Individual
Prefix:
First Name:KIRAN
Middle Name:
Last Name:VOHRA
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:SOUTHSIDE HOSPITAL-DEPT OF PEDIATRICS
Mailing Address - Street 2:301 EAST MAIN STREET
Mailing Address - City:BAYSHORE
Mailing Address - State:NY
Mailing Address - Zip Code:11706
Mailing Address - Country:US
Mailing Address - Phone:631-968-3460
Mailing Address - Fax:
Practice Address - Street 1:SOUTHSIDE HOSPITAL-DEPT OF PEDIATRICS
Practice Address - Street 2:301 EAST MAIN STREET
Practice Address - City:BAYSHORE
Practice Address - State:NY
Practice Address - Zip Code:11706
Practice Address - Country:US
Practice Address - Phone:631-968-3460
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1363812080N0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080N0001XAllopathic & Osteopathic PhysiciansPediatricsNeonatal-Perinatal Medicine