Individual ProviderPruthvi Chenniganahosahalli RevaiahStudent in an Organized Health Care Education/Training ProgramStudent, Health CarePractice AddressOne Gustave L.Levy Place Box 1030, Mount Sinai Hospital, New York, NY 10029(212) 241-3419PECOS EnrollmentBased on the most recent information from CMS, provider Pruthvi Chenniganahosahalli Revaiah does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1255137378Provider TypeIndividualFull NameChenniganahosahalli Revaiah, PruthviTitleMr.CredentialM.B.B.S., M.D., D.MGenderMaleSole ProprietorNoEnumeration Date2/20/2025Last Updated2/20/2025Contact InformationPractice LocationPractice AddressOne Gustave L.Levy Place Box 1030, Mount Sinai Hospital, New York, NY 10029Phone(212) 241-3419FaxUnlisted FaxMailing LocationMailing AddressOne Gustave L.Levy Place Box 1030, Mount Sinai Hospital, New York, NY 10029Phone(212) 241-3419FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode390200000XPrimaryDescriptionStudent in an Organized Health Care Education/Training ProgramStudent, Health CareLicenseUnlisted Issuer