Provider Demographics
NPI:1609450907
Name:TANEJA, KRISHNA SMRITI (MD, MBA)
Entity type:Individual
Prefix:
First Name:KRISHNA
Middle Name:SMRITI
Last Name:TANEJA
Suffix:
Gender:F
Credentials:MD, MBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3702 S 4TH ST
Mailing Address - Street 2:
Mailing Address - City:TERRE HAUTE
Mailing Address - State:IN
Mailing Address - Zip Code:47802-5507
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3901 S 7TH ST
Practice Address - Street 2:
Practice Address - City:TERRE HAUTE
Practice Address - State:IN
Practice Address - Zip Code:47802-4299
Practice Address - Country:US
Practice Address - Phone:812-232-0021
Practice Address - Fax:877-865-9738
Is Sole Proprietor?:No
Enumeration Date:2021-05-12
Last Update Date:2025-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL125.0774282084P0800X
IN01096207A2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry