Individual
MALLIKARJUNA YALAMANCHILI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
355 BARD AVE, STATEN ISLAND, NY 10310
(718) 818-1234
Mailing address
4459 AMBOY RD, STATEN ISLAND, NY 10312-3846
(718) 948-6177
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
185213
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01348778
—
NY
Enumeration date
01/19/2006
Last updated
09/24/2013
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