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NPI Code Detail

MEDICARE: VENU CHANNAMSETTY MD

MEDICARE: VENU CHANNAMSETTY MD
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
1207RC0000XCardiovascular Disease Physician240059NY

General Provider Information

NPI Number : 1760516041
Entity Type Code : Individual
Provider Name (Legal Business Name) : VENU CHANNAMSETTY MD
Provider Business Mailing Address
First Line : 2660 MAIN ST STE 216
Second Line :
City : BRIDGEPORT
State : CT
Zip : 06606-5301
Country : US
Telephone Number : 203-385-1133
Fax Number :
Provider Business Practice Location Address
First Line : 2979 MAIN ST
Second Line :
City : BRIDGEPORT
State : CT
Zip : 06606-4284
Country : US
Telephone Number : 203-683-5110
Fax Number : 203-683-5140
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/16/2007
Last Update Date : 10/03/2017

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Directions to “ VENU CHANNAMSETTY MD” Practice Location

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