Upper West Side Medical Doctor PLLC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

UPPER WEST SIDE MEDICAL DOCTOR PLLC

Practice address

46 W 86TH St Ste 1a
New York, NY 10024-3633

Phone

(908) 962-1000

Fax

(908) 962-1000

NPI assigned

Sep 30, 2017

Last updated

Dec 5, 2017By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Bhavana Kranthi, MD

Title

Owner

Phone

(732) 429-6513

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1506729600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1512432000000",
    "number": "1912417254",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "46 W 86TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100243633",
            "telephone_number": "732-429-6513",
            "fax_number": "917-472-1525"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "46 W 86TH ST STE 1A",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100243633",
            "telephone_number": "908-962-1000",
            "fax_number": "908-962-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UPPER WEST SIDE MEDICAL DOCTOR PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-09-30",
        "last_updated": "2017-12-05",
        "status": "A",
        "authorized_official_last_name": "KRANTHI",
        "authorized_official_first_name": "BHAVANA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "732-429-6513",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NY STATE LICENSE",
            "identifier": "287857",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Upper West Side Chiropractic PLLC
• Upper West Side Dermatology Inc
• Upper West Side Dermatology, P.C.
• Upper West Side Family Medical Practice (Vincent Esposito MD)
• Upper West Side Medical Associates PC
• Upper West Side Medical P.L.L.C.
• Upper West Side Oral & Maxillofacial Surgery
• Upper West Side Podiatry PC
• Upper Westside Opthalmology Eyecare
• Upper Westside Surgical Group

• Clinic/Center in New York, NY
• Providers in New York, NY by specialty
• Clinic/Center in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2017; 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.