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Individual

ANGANA MAHAPATRA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
D.O.

Contact information

Practice address
725 IRVING AVE STE 311, SYRACUSE, NY 13210-1685
(315) 464-5815
(315) 464-9150
Mailing address
725 IRVING AVE STE 311, SYRACUSE, NY 13210-1685
(315) 464-5815
(315) 464-9150

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
276703-1
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
04193239
NY
Enumeration date
07/07/2012
Last updated
12/11/2018
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