Provider Demographics
NPI:1992434575
Name:GOPALAN, KAVITHA (MD)
Entity type:Individual
Prefix:MRS
First Name:KAVITHA
Middle Name:
Last Name:GOPALAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3450 WAYNE AVE APT 22E
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10467-2513
Mailing Address - Country:US
Mailing Address - Phone:929-398-8913
Mailing Address - Fax:
Practice Address - Street 1:100 WOODS RD
Practice Address - Street 2:
Practice Address - City:VALHALLA
Practice Address - State:NY
Practice Address - Zip Code:10595-1530
Practice Address - Country:US
Practice Address - Phone:914-367-0000
Practice Address - Fax:914-367-0001
Is Sole Proprietor?:No
Enumeration Date:2022-06-08
Last Update Date:2025-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program