Active NPI
Kumaraswamy Gollarahally-Kenchap, PHD
- Clinical Medical Laboratory
- Irvington, NJ
National Provider Identifier
1689487035
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Medical Laboratory
- License
- PFI9647
- Practice address
- 22 Ball St
Irvington, NJ 07111-3521 - Phone
- (973) 877-8357
- NPI assigned
- Jan 29, 2025
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Medical Laboratory | 291U00000X | PFI9647 | NY | Primary |
Addresses
Primary practice location
22 Ball St
Irvington, NJ 07111-3521
Mailing address
22 Ball St
Irvington, NJ 07111-3521
Phone (973) 877-8357
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PFI9647 | NY | MD | Clinical Medical Laboratory |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1738108800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1738108800000",
"number": "1689487035",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "22 BALL ST",
"city": "IRVINGTON",
"state": "NJ",
"postal_code": "071113521",
"telephone_number": "973-877-8357"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "22 BALL ST",
"city": "IRVINGTON",
"state": "NJ",
"postal_code": "071113521",
"telephone_number": "973-877-8357"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOLLARAHALLY-KENCHAP",
"first_name": "KUMARASWAMY",
"credential": "PHD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2025-01-29",
"last_updated": "2025-01-29",
"certification_date": "2025-01-29",
"status": "A"
},
"taxonomies": [
{
"code": "291U00000X",
"taxonomy_group": "",
"desc": "Clinical Medical Laboratory",
"state": "NY",
"license": "PFI9647",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Irvington, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.