Individual
PRATHIMA KANUMURI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2210 TROY SCHENECTADY RD, NISKAYUNA, NY 12309-4725
(518) 612-8560
(518) 612-8561
Mailing address
1201 NOTT ST, SUITE 103, SCHENECTADY, NY 12308-2589
(518) 612-8560
(518) 612-8561
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
256886
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04227556
—
NY
Enumeration date
08/07/2007
Last updated
03/30/2018
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