1124350848 NPI number — DR. KRISHNA BANERJEE MD, MRCP, FRCPCH

Table of content: DR. KRISHNA BANERJEE MD, MRCP, FRCPCH (NPI 1124350848)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1124350848 NPI number — DR. KRISHNA BANERJEE MD, MRCP, FRCPCH

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BANERJEE
Provider First Name:
KRISHNA
Provider Middle Name:
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD, MRCP, FRCPCH
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
BANDYOPADHYAY
Provider Other First Name:
KRISHNA
Provider Other Middle Name:
Provider Other Name Prefix Text:
DR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
MD
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1124350848
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/15/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
800 WASHINGTON ST
Provider Second Line Business Mailing Address:
#334
Provider Business Mailing Address City Name:
BOSTON
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
02111-1552
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
617-636-7242
Provider Business Mailing Address Fax Number:
617-636-5621

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
800 WASHINGTON ST
Provider Second Line Business Practice Location Address:
#334
Provider Business Practice Location Address City Name:
BOSTON
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
02111-1552
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
617-636-7242
Provider Business Practice Location Address Fax Number:
617-636-5621
Provider Enumeration Date:
02/04/2010

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 2080P0006X , with the licence number:  243288 , registered in the state of MA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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