Provider Demographics
NPI:1902965353
Name:KRIPALANI, JAY R (MD)
Entity Type:Individual
Prefix:
First Name:JAY
Middle Name:R
Last Name:KRIPALANI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15905 92ND ST
Mailing Address - Street 2:
Mailing Address - City:HOWARD BEACH
Mailing Address - State:NY
Mailing Address - Zip Code:11414-3123
Mailing Address - Country:US
Mailing Address - Phone:718-835-3636
Mailing Address - Fax:718-835-0897
Practice Address - Street 1:15905 92ND ST
Practice Address - Street 2:
Practice Address - City:HOWARD BEACH
Practice Address - State:NY
Practice Address - Zip Code:11414-3123
Practice Address - Country:US
Practice Address - Phone:718-835-3636
Practice Address - Fax:718-835-0897
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-08
Last Update Date:2022-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY215285207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYH29680Medicare UPIN