Individual
DEEPA KUMARAIAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD, MBA
Contact information
Practice address
622 W 168TH ST, NEW YORK, NY 10032-3720
(917) 415-0510
Mailing address
630 W 168TH ST, BOX 4, NEW YORK, NY 10032-3725
(212) 342-5155
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
266755
NY
207R00000X
Internal Medicine Physician
L-240186
MA
207RC0000X
Cardiovascular Disease Physician
Primary
266755
NY
Other
Enumeration date
06/11/2009
Last updated
01/13/2016
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