Healthcare Provider Details

I. General information

NPI: 1982140554
Provider Name (Legal Business Name): ANTARA SATCHIDANAND M.A.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/06/2017
Last Update Date: 07/09/2026
Certification Date: 07/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1085 EGGERT RD
AMHERST NY
14226-4148
US

IV. Provider business mailing address

258 GRIMSBY RD
BUFFALO NY
14223-1921
US

V. Phone/Fax

Practice location:
  • Phone: 716-831-8422
  • Fax: 716-831-8428
Mailing address:
  • Phone: 716-544-9904
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number027313
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: