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:
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Health care specialties

SpecialtyCodeLicense #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 16 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 1275534711 NPPES
New York MEDICAID 01124258

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