Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RH0003X | Hematology & Oncology | 287081 | NY |
NPI | 1033405154 |
---|---|
Provider Name | Dr. Nischala Ammannagari |
First Address | Halfmoon, NY 12065-3239 |
Second Address | Albany, NY 12206-5014 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/06/2011 |
Last Update Date | 26/09/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
04891250 | (05) | NY |