Organization
KINGSTON SURGICAL, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KALYAN R VENKAT M.D. (SOLE PROPRIETOR)
(845) 338-3212
Entity
Organization
Contact information
Practice address
40 HURLEY AVE, SUITE 17, KINGSTON, NY 12401-3739
(845) 338-3212
(845) 339-0299
Mailing address
40 HURLEY AVE, SUITE 17, KINGSTON, NY 12401-3739
(845) 338-3212
(845) 339-0299
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
136378-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00573331
—
NY
Enumeration date
11/17/2006
Last updated
08/22/2020
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