MEDICARE: DR. PRABHAKAR VEERAMACHANENI M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207L00000X	Anesthesiology Physician	145591	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1578597068
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PRABHAKAR VEERAMACHANENI M.D.

Provider Business Mailing Address
First Line	:	302 MANOR RD
Second Line	:
City	:	STATEN ISLAND
State	:	NY
Zip	:	10314-2408
Country	:	US
Telephone Number	:	718-815-1000
Fax Number	:	718-815-8122

Provider Business Practice Location Address
First Line	:	7124 18TH AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11204-5203
Country	:	US
Telephone Number	:	718-234-3333
Fax Number	:	718-815-8122

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/10/2006
Last Update Date	:	07/08/2007

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