Provider Demographics
NPI:1174626105
Name:KARHADE, NAGORAO V (MD , FACC)
Entity type:Individual
Prefix:
First Name:NAGORAO
Middle Name:V
Last Name:KARHADE
Suffix:
Gender:M
Credentials:MD , FACC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2 CORACI BLVD
Mailing Address - Street 2:SUITE 8
Mailing Address - City:SHIRLEY
Mailing Address - State:NY
Mailing Address - Zip Code:11967-4833
Mailing Address - Country:US
Mailing Address - Phone:631-399-6003
Mailing Address - Fax:631-399-6011
Practice Address - Street 1:2 CORACI BLVD
Practice Address - Street 2:SUITE 8
Practice Address - City:SHIRLEY
Practice Address - State:NY
Practice Address - Zip Code:11967-4833
Practice Address - Country:US
Practice Address - Phone:631-399-6003
Practice Address - Fax:631-399-6011
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-06
Last Update Date:2016-02-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY189091207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01355875Medicaid
NYH14691Medicare UPIN
NY01355875Medicaid