| Bangaruraju Kolanuvada Medical Pc | |
|
970 N Broadway Ste 206 Yonkers NY 10701-1310 | |
| (914) 969-7100 | |
| Not Available |
| Full Name | Bangaruraju Kolanuvada Medical Pc |
|---|---|
| Speciality | Internal Medicine |
| Location | 970 N Broadway Ste 206, Yonkers, New York |
| Authorized Official Name and Position | Bangaruraju Kolanuvada (MD) |
| Authorized Official Contact | 9147201047 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Bangaruraju Kolanuvada Medical Pc 1 Forest Blvd Ardsley NY 10502-1003 Ph: () - | Bangaruraju Kolanuvada Medical Pc 970 N Broadway Ste 206 Yonkers NY 10701-1310 Ph: (914) 969-7100 |
| NPI Number | 1528566254 |
|---|---|
| Provider Enumeration Date | 01/29/2018 |
| Last Update Date | 03/17/2018 |
| Medicare PECOS PAC ID | 9436405636 |
|---|---|
| Medicare Enrollment ID | O20180702000062 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1528566254 | NPI | - | NPPES |
| 02499383 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 228890 (New York) | Primary |
| Provider Name | Bangaruraju Kolanuvada |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1689648545 PECOS PAC ID: 8729971742 Enrollment ID: I20040204000495 |
| Provider Name | Saleela C Raja |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538463534 PECOS PAC ID: 4183807993 Enrollment ID: I20110331000242 |
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