Organization
BANGARURAJU KOLANUVADA MEDICAL PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BANGARURAJU KOLANUVADA (MD)
(914) 720-1047
Entity
Organization
Contact information
Practice address
970 N BROADWAY STE 206, YONKERS, NY 10701-1310
(914) 969-7100
Mailing address
1 FOREST BLVD, ARDSLEY, NY 10502-1003
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
228890
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02499383
—
NY
Enumeration date
01/29/2018
Last updated
03/17/2018
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