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Individual

NAGENDRANATH DHANYAMRAJU

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1300 MASSACHUSETTS AVE, TROY, NY 12180-1628
(518) 268-5554
(518) 268-5396
Mailing address
3998 FAIR RIDGE DRIVE, SUITE 300, FAIRFAX, VA 22033-2921
(703) 295-9360
(703) 766-9725

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
204569
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000490204001
BSNENY
NY
05
01749504
NY
01
05010
MVP
NY
01
10023510
CDPHP
NY
01
204569-8AN
WC
NY
01
5399982
GHI
NY
01
66A641
EMPIRE BS
NY
01
7459616
AETNA
NY
Enumeration date
08/25/2006
Last updated
04/24/2015
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