Provider Demographics
NPI:1225909542
Name:SHENOY, KUNDAPUR NAGESH
Entity type:Individual
Prefix:
First Name:KUNDAPUR
Middle Name:NAGESH
Last Name:SHENOY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:560 AMERICAN AVE
Mailing Address - Street 2:
Mailing Address - City:KING OF PRUSSIA
Mailing Address - State:PA
Mailing Address - Zip Code:19406-1442
Mailing Address - Country:US
Mailing Address - Phone:484-954-8846
Mailing Address - Fax:
Practice Address - Street 1:560 AMERICAN AVE
Practice Address - Street 2:
Practice Address - City:KING OF PRUSSIA
Practice Address - State:PA
Practice Address - Zip Code:19406-1442
Practice Address - Country:US
Practice Address - Phone:484-954-8846
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-17
Last Update Date:2025-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP459833183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty