Mahadevan G Krishnan, MD PC

Primary specialty

Vascular Surgery PhysicianTaxonomy code 2086S0129X

License

25MA045854 Issued in NJ

Legal business name

MAHADEVAN G KRISHNAN, MD PC

Practice address

609 River Ave
Lakewood, NJ 08701-5227

Phone

(732) 901-8822

Fax

(732) 367-2897

NPI assigned

Nov 17, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Mahadevan G Krishnan, MD

Title

President

Phone

(732) 901-8822

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Lalitha Krishnan, MD

  • Internal Medicine Physician
  • Toms River, NJ
  • NPI 1669555793
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1163721600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1354060800000",
    "number": "1407929185",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "609 RIVER AVE",
            "city": "LAKEWOOD",
            "state": "NJ",
            "postal_code": "087015227",
            "telephone_number": "732-901-8822",
            "fax_number": "732-367-2897"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "609 RIVER AVE",
            "city": "LAKEWOOD",
            "state": "NJ",
            "postal_code": "087015227",
            "telephone_number": "732-901-8822",
            "fax_number": "732-367-2897"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAHADEVAN G KRISHNAN, MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-17",
        "last_updated": "2012-11-28",
        "status": "A",
        "authorized_official_last_name": "KRISHNAN",
        "authorized_official_first_name": "MAHADEVAN",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "732-901-8822",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery, Vascular Surgery",
            "state": "NJ",
            "license": "25MA045854",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "DB3539",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Madison Dental Associates,PA
• Madison Dental Care PA
• Madison Infusion Center
• Madison RX LLC
• Magical Steps ABA LLC
• Darshana Mahapatro, MD
• Mahmood-Schor Urology, P.a.
• Dina Maierovits, MS RD
• Susan L Mailman-Frid
• Jared Eli Maiman, DMD

• Vascular Surgery Physician in Lakewood, NJ
• Providers in Lakewood, NJ by specialty
• Vascular Surgery Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.