Provider Demographics
NPI:1548299795
Name:KUNDU, ROOPAL (MD)
Entity type:Individual
Prefix:
First Name:ROOPAL
Middle Name:
Last Name:KUNDU
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:560 FIRST AVENUE
Mailing Address - Street 2:SUITE H116A
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-6497
Mailing Address - Country:US
Mailing Address - Phone:212-263-5250
Mailing Address - Fax:
Practice Address - Street 1:560 FIRST AVENUE
Practice Address - Street 2:SUITE H116A
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-6497
Practice Address - Country:US
Practice Address - Phone:212-263-5250
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-01
Last Update Date:2008-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY244237207N00000X
IL207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
I30651Medicare UPIN
NY4K2031Medicare PIN