Healthcare Provider Details

I. General information

NPI: 1447208160
Provider Name (Legal Business Name): KAMALAMMA A DUVVI MD
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 05/05/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2094 ALBANY POST RD VA HVHCS
MONTROSE NY
10548-1454
US

IV. Provider business mailing address

35 WILLIAM PUCKEY DR
CORTLANDT MANOR NY
10567-6215
US

V. Phone/Fax

Practice location:
  • Phone: 914-737-4400
  • Fax: 914-788-4304
Mailing address:
  • Phone: 914-737-6861
  • Fax: 914-737-6861

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0805X
TaxonomyGeriatric Psychiatry Physician
License Number132202
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: