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VISHNUDAS PANEMANGLORE PAI

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
6 WELLNESS WAY STE G03, LATHAM, NY 12110-2156
(518) 785-5884
(518) 783-6890
Mailing address
6 WELLNESS WAY STE 201, LATHAM, NY 12110-2156

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
238785
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
02777195
NY
01
071202000026
FIDELIS
01
10126571
CDPHP
01
4158774
MVP
01
6655H1
EMPIRE BLUE CROSS
01
7578940
AETNA
01
P00617034
RAILROAD MEDICARE
Enumeration date
06/03/2006
Last updated
03/07/2024
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