Individual
DR. PRASAD V KAMBHAMPATI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2209 GENESEE ST, UTICA, NY 13501-5930
(315) 798-9788
Mailing address
2405 GENESEE ST, UTICA, NY 13501-6214
(315) 798-9788
(315) 798-9766
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
1908371
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00931237
MEDICAID
—
01
—
01573028
PALMETTO
—
01
—
050128000091
FIDELIS
—
01
—
100130750701
UNITED HEALTH MEDICAID
NY
01
—
10068155
CDPHP
NY
01
—
10495544
CAQH
NY
01
—
1307507
UHC
NY
05
—
1573028
—
NY
01
—
207045400
US DEPT OF LABOR
NY
01
—
54602A
MEDICARE
—
01
—
950862
MUP
—
Enumeration date
10/28/2005
Last updated
10/26/2010
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