Mandava, Amrutha Chandra

Mandava, Amrutha Chandra is an individual health care provider with primary practice located at 1662 Central Ave , Albany NY 12205. He recently has only one registered license in Dental Providers / General Practice, which is considered as his primary health care specialty. Mandava, Amrutha Chandra can be contacted via phone (518) 452-2121.

Contact Information

Primary practice address
1662 Central Ave Albany NY 12205
Fax: (518) 456-2865
Website:

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X 042469 New York

Profile Details

NPI number 1053370882
LBN Legal business name Mandava, Amrutha Chandra
Credentials Doctor of Dental Medicine (DMD)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 21st, 2006
Last updated Aug 24th, 2009 - about 17 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1053370882 NPPES
New York Other 795808 UNITED CONCORDIA

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