Provider Demographics
NPI:1548299795
Name:KUNDU, ROOPAL V (MD)
Entity type:Individual
Prefix:
First Name:ROOPAL
Middle Name:V
Last Name:KUNDU
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ROOPAL
Other - Middle Name:A
Other - Last Name:VASHI
Other - Suffix:
Other - Last Name Type:Other Name
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 1:676 N SAINT CLAIR ST STE 1600
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60611-2997
Practice Address - Country:US
Practice Address - Phone:312-695-8106
Practice Address - Fax:312-695-0664
Is Sole Proprietor?:No
Enumeration Date:2006-07-01
Last Update Date:2025-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY244237207N00000X
IL036110878207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
I30651Medicare UPIN
NY4K2031Medicare PIN