Provider Demographics
NPI:1871797431
Name:KRISHNA, MURALI G (MD)
Entity type:Individual
Prefix:DR
First Name:MURALI
Middle Name:G
Last Name:KRISHNA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:MURALIKRISHNA
Other - Middle Name:
Other - Last Name:GOPALAKRISHNAMOORTHY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:160 N MIDLAND AVE FL 2
Mailing Address - Street 2:
Mailing Address - City:NYACK
Mailing Address - State:NY
Mailing Address - Zip Code:10960-1912
Mailing Address - Country:US
Mailing Address - Phone:845-203-1212
Mailing Address - Fax:
Practice Address - Street 1:160 N MIDLAND AVE FL 2
Practice Address - Street 2:
Practice Address - City:NYACK
Practice Address - State:NY
Practice Address - Zip Code:10960-1912
Practice Address - Country:US
Practice Address - Phone:845-203-1212
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-14
Last Update Date:2021-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY274574207R00000X, 207RC0200X, 207RP1001X, 207RP1001X, 207RS0012X, 207RC0200X
FLME112562207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03917168Medicaid
3858891241OtherMYUTMB 3858891241-COMMERCIAL NUMBER
3858891241OtherMYUTMB 3858891241-COMMERCIAL NUMBER