Individual
KUMAR KRISHNAMOORTHI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
P.T.
Contact information
Practice address
25 AVALON RD, HEWLETT, NY 11557-1401
(516) 837-0356
(516) 837-0356
Mailing address
25 AVALON RD, HEWLETT, NY 11557-1401
(516) 837-0356
(516) 837-0356
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
015503-1
NY
Other
Enumeration date
01/13/2009
Last updated
01/13/2009
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