Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 280894 | NY |
N | 111NI0900X | Internist | 280894 | NY |
Y | 207RA0401X | Internist - Addiction Medicine | 280894 | NY |
NPI | 1104183144 |
---|---|
Provider Name | Dr. Anuradha Mendu |
First Address | Buffalo, NY 14228-3744 |
Second Address | Buffalo, NY 14215 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/04/2012 |
Last Update Date | 01/11/2021 |