Healthcare Provider Details
I. General information
NPI: 1487235909
Provider Name (Legal Business Name): NAMITA NEERUKONDA ARBOLEDA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 04/16/2021
Last Update Date: 09/08/2025
Certification Date: 09/08/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
600 ROE AVE
ELMIRA NY
14905-1676
US
IV. Provider business mailing address
600 IVY ST STE 206
ELMIRA NY
14905-1627
US
V. Phone/Fax
- Phone: 607-737-7012
- Fax: 607-733-5594
- Phone: 607-271-2093
- Fax: 607-271-2071
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2084P0800X |
| Taxonomy | Psychiatry Physician |
| License Number | 331891 |
| License Number State | NY |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: