Individual
DR. JOLLY RADHAKRISHNAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1111 AMSTERDAM AVENUE, NEW YORK, NY 10025-1716
(718) 960-1411
(718) 518-5124
Mailing address
44 MORNINGSIDE DR, APT 52, NEW YORK, NY 10025-1719
(212) 666-2371
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
198130
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01605536
—
NY
Enumeration date
09/25/2006
Last updated
12/04/2009
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