Individual
DR. KALPATHY S KRISHNAMOORTHY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
55 FRUIT ST, YAW 6, PEDIATRIC NEUROLOGY, BOSTON, MA 02114
(617) 726-3877
(617) 724-7860
Mailing address
PO BOX 9142, MASS GENERAL PHYSICIAN ORGANIZATION, CHARLESTOWN, MA 02129-9142
(617) 726-3877
(617) 726-7860
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
36248
MA
2084N0400X
Neurology Physician
Primary
36248
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2033135
—
MA
01
—
700053
TUFTS HEALTH PLAN
MA
01
—
M08904
BCBS MA
MA
Enumeration date
03/03/2006
Last updated
03/07/2013
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