Individual
DR. CHAMKIRKISHTIAH PANDURANGA RAO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
19 W MAIN ST, MOHAWK, NY 13407-1024
(315) 866-7766
Mailing address
19 W MAIN ST, MOHAWK, NY 13407-1024
(315) 866-7766
Taxonomy
Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
150274
NY
208000000X
Pediatrics Physician
Primary
150274
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00803269
—
NY
Enumeration date
09/20/2006
Last updated
03/26/2024
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