Healthcare Provider Details
I. General information
NPI: 1770788911
Provider Name (Legal Business Name): ANITHA VEMPATY SHRIKHANDE MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 06/18/2007
Last Update Date: 03/11/2016
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
99 CANAL LANDING BLVD SUITE 7
ROCHESTER NY
14626-5112
US
IV. Provider business mailing address
99 CANAL LANDING BLVD SUITE 7
ROCHESTER NY
14626-5112
US
V. Phone/Fax
- Phone: 585-723-8710
- Fax: 585-723-8395
- Phone: 585-723-8710
- Fax: 585-723-8395
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207KA0200X |
| Taxonomy | Allergy Physician |
| License Number | 253083 |
| License Number State | NY |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: