Individual
VINAY N KIKKERI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
360 BARD AVE, STATEN ISLAND, NY 10310-1666
(718) 876-2000
(718) 876-2012
Mailing address
360 BARD AVE, STATEN ISLAND, NY 10310-1666
(718) 876-2000
(718) 876-2012
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
250734
NY
2085R0204X
Vascular & Interventional Radiology Physician
Primary
250734
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02458166
—
NY
Enumeration date
12/28/2005
Last updated
12/20/2021
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