Individual
DR. KALLANNA MANJUNATH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
920 LARK DR, ALBANY, NY 12207-1300
(518) 465-4771
(518) 242-4784
Mailing address
920 LARK DR, ALBANY, NY 12207-1300
(518) 465-4771
(518) 242-4784
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
169790
NY
Other
Enumeration date
11/02/2005
Last updated
04/03/2012
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