Basic Information
| Provider Information | |||||||||
| NPI: | 1588014039 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | KAVURI | ||||||||
| FirstName: | HYMAVATI | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1320 4TH ST NE APT 614 | ||||||||
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| City: | WASHINGTON | ||||||||
| State: | DC | ||||||||
| PostalCode: | 200027151 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5624136280 | ||||||||
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| Practice Location | |||||||||
| Address1: | 765 KENILWORTH TER NE | ||||||||
| Address2: | |||||||||
| City: | WASHINGTON | ||||||||
| State: | DC | ||||||||
| PostalCode: | 200191898 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2024694699 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/15/2016 | ||||||||
| LastUpdateDate: | 05/17/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 05/17/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 300626 | NY | N | Allopathic & Osteopathic Physicians | Family Medicine | 207Q00000X | 210001681 | DC | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.