Mandava, Nageswara R
Mandava, Nageswara R is an sole proprietor health care provider with primary practice located at 14601 45Th Ave Suite 405, Flushing NY 11355-2200. He recently has only one registered license in Allopathic & Osteopathic Physicians / Surgical Oncology, which is considered as his primary health care specialty. Mandava, Nageswara R can be contacted via phone (718) 670-5202.Contact Information
Primary practice address
14601 45Th Ave Suite 405
Flushing NY 11355-2200
Phone: (718) 670-5202
Fax: (718) 670-5312
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Surgical Oncology | 2086X0206X | 165321 | New York |
Profile Details
| NPI number | 1275534711 |
|---|---|
| LBN Legal business name | Mandava, Nageswara R |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Aug 9th, 2005 |
| Last updated | Jun 17th, 2010 - about 14 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1275534711 | NPPES |
| New York | MEDICAID | 01124258 |
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