Individual
BALACHANDAR JANAMALA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
825 57TH ST, LONGEVOUS MEDICAL HEALTHCARE, PC, BROOKLYN, NY 11220
(646) 750-2090
Mailing address
8395 MAGNOLIA AVE APT NO, RIVERSIDE, CA 92504-3224
(951) 750-9284
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
040729
NY
Other
Enumeration date
09/01/2016
Last updated
09/01/2016
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