Provider Demographics
NPI:1538566252
Name:BHANDARKAR, KAILAS (MD)
Entity type:Individual
Prefix:
First Name:KAILAS
Middle Name:
Last Name:BHANDARKAR
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 1:425 E 76TH ST
Mailing Address - Street 2:7F
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10021-2510
Mailing Address - Country:US
Mailing Address - Phone:347-282-4225
Mailing Address - Fax:
Practice Address - Street 1:425 E 76TH ST
Practice Address - Street 2:7F
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021-2510
Practice Address - Country:US
Practice Address - Phone:347-282-4225
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-11-24
Last Update Date:2014-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYP944612086S0120X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0120XAllopathic & Osteopathic PhysiciansSurgeryPediatric Surgery