Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207R00000X | Internist | 214279-1 | NY |
Y | 111NI0900X | Internist | 214279-1 | NY |
N | 207RG0300X | Geriatric Medicine | 2142791 | NY |
NPI | 1053429829 |
---|---|
Provider Name | Umamaheswara Rao Vejendla Physician Pc |
First Address | Jamestown, NY 14701-6940 |
Second Address | Jamestown, NY 14701-6940 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 29/08/2006 |
Last Update Date | 24/08/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
02050080 | (05) | NY |
040426003867 | FIDELIS (01) | NY |
0410963 | INDEPENDENT HEALTH (01) | NY |
161070314 | NOVA (01) | NY |
21017301 | UNIVERA (01) | NY |
52060000 | UNIVERA SR. SHOICE (01) | NY |
525874001 | BLUE CROSS (01) | NY |
H08349 | (02) | NY |