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Individual

AVINASH BODDAPATI

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
18707 HARDY OAK BLVD STE 410, SAN ANTONIO, TX 78258-4791
(877) 504-8504
Mailing address
450 SEAVIEW AVE, STATEN ISLAND, NY 10305-3401
(718) 226-9000

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
282697
NY
2084P0800X
Psychiatry Physician
Primary
T8492
TX
2084P0804X
Child & Adolescent Psychiatry Physician
282697
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0-4365486
NY
Enumeration date
06/28/2011
Last updated
01/13/2023
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