Provider Demographics
NPI:1174526925
Name:KRISHNA, AKULA V (MD)
Entity type:Individual
Prefix:DR
First Name:AKULA
Middle Name:V
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 1:1201 NOTT ST
Mailing Address - Street 2:STE 306
Mailing Address - City:SCHENECTADY
Mailing Address - State:NY
Mailing Address - Zip Code:12308-2589
Mailing Address - Country:US
Mailing Address - Phone:518-377-6950
Mailing Address - Fax:518-377-9258
Practice Address - Street 1:1201 NOTT ST
Practice Address - Street 2:STE 306
Practice Address - City:SCHENECTADY
Practice Address - State:NY
Practice Address - Zip Code:12308-2589
Practice Address - Country:US
Practice Address - Phone:518-377-6950
Practice Address - Fax:518-377-9258
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-05-24
Last Update Date:2007-07-08
Deactivation Date:2006-03-16
Deactivation Code:
Reactivation Date:2006-03-24
Provider Licenses
StateLicense IDTaxonomies
NY1215932086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00531966Medicaid
NYB80723Medicare UPIN
33477CMedicare ID - Type Unspecified