Sarala Radhakrishnan, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

178781 Issued in NY

Practice address

640 Montauk Hwy
Suite a
Shirley, NY 11967-2115

Phone

(631) 399-8802

Fax

(631) 399-8804

NPI assigned

Oct 21, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1161388800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1689757031",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "640 MONTAUK HWY",
            "address_2": "SUITE A",
            "city": "SHIRLEY",
            "state": "NY",
            "postal_code": "119672115",
            "telephone_number": "631-399-8802",
            "fax_number": "631-399-8804"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "640 MONTAUK HWY",
            "address_2": "SUITE A",
            "city": "SHIRLEY",
            "state": "NY",
            "postal_code": "119672115",
            "telephone_number": "631-399-8802",
            "fax_number": "631-399-8804"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RADHAKRISHNAN",
        "first_name": "SARALA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "178781",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01508621",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Frank Joseph Pollina, OPHTHALMIC DISPENSE
• Wendy Carol Ports
• Joseph William Primavera, PHARM D.
• Debra A Pure, CRPA
• Lalaine T Que, MD
• Kaveh Rafiei, PHARM.D
• Iryna Ivanovna Rahalevich, NP
• Carmen V Ramirez
• Roland Johnathan Ramkissoon, PA-C
• Darla Ramos

• Pediatrics Physician in Shirley, NY
• Providers in Shirley, NY by specialty
• Pediatrics Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.