Mandavilli, Bela S
Mandavilli, Bela S is an individual health care provider with primary practice located at 111 Founders Plz #300 C/O Ipms, East Hartford CT 06108-3212. She recently has only one registered license in Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology, which is considered as her primary health care specialty. Mandavilli, Bela S can be contacted via phone (860) 282-4137.Contact Information
Primary practice address
111 Founders Plz #300 C/O Ipms
East Hartford CT 06108-3212
Phone: (860) 282-4137
Fax: (860) 282-0170
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology | 207ZP0102X | 037000 | Connecticut |
Profile Details
| NPI number | 1417948712 |
|---|---|
| LBN Legal business name | Mandavilli, Bela S |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Nov 4th, 2005 |
| Last updated | Jan 24th, 2020 - about 6 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 | 1417948712 | NPPES |
| Connecticut | MEDICAID | 001370006 |
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