Individual
DR. SHIBU KINATUKARA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
1640 OCEAN AVE, SUITE 1B, BROOKLYN, NY 11230-4963
(718) 258-4100
(718) 251-1856
Mailing address
1977 RALPH AVE STE 418, BROOKLYN, NY 11234-5416
(718) 258-4100
(718) 251-1122
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
NOO5595
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0051331
—
NJ
05
—
2205136
—
NY
01
—
2287975
UNITED HEALTHCARE
NY
01
—
4695
GHI MEDICARE
NY
01
—
6299162
GHI
NY
01
—
P2743644
OXFORD
NY
Enumeration date
05/03/2006
Last updated
06/14/2024
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