Provider Demographics
NPI:1730151218
Name:KRISHNA, RANGA CHELVA (MD)
Entity type:Individual
Prefix:DR
First Name:RANGA
Middle Name:CHELVA
Last Name:KRISHNA
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 1:1513 VOORHIES AVE
Mailing Address - Street 2:1ST FLOOR
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11235-3994
Mailing Address - Country:US
Mailing Address - Phone:718-332-7878
Mailing Address - Fax:718-332-8051
Practice Address - Street 1:1513 VOORHIES AVE
Practice Address - Street 2:1ST FLOOR
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11235-3994
Practice Address - Country:US
Practice Address - Phone:718-332-7878
Practice Address - Fax:718-332-8051
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-07
Last Update Date:2012-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1941982084N0400X
NY194918204D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
No204D00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine & OMM
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY116750101OtherHEALTH PLUS
NY1730151218OtherVNS OF NY
NY504751OtherEMPIRE HEALTHCHOICE
NYP00008944OtherRAIL ROAD MEDICARE
NY000116750101OtherHEALTH PLUS AMERIGROUP SOLUTION
NY5527395OtherAETNA PPO
NY194198-A21OtherHEALTH FIRST
NY6014163OtherGHI
NY010194198NY01OtherAMERICHOICE
NY100181179001OtherUHC COMMUNITY PLAN
NYP1105203OtherOXFORD
NY31914POtherHIP
NY000181170OtherUNITED HEALTHCARE
NY01688375Medicaid
107945000OtherLABOR DEPT.
NY132655001KR01OtherCARE PLUS
NY2144578OtherAETNA HMO
NY5527395OtherAETNA PPO
NY504751Medicare ID - Type Unspecified