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General NPI Number Information
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NPI Number | 1083166045
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Entity Type | Individual
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Provider Name | YANDAMA BANGURA
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Gender | Female
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Dates
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Enumeration Date | 10/25/2016
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Last Update Date | 07/26/2025
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Provider Practice Location Address
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Address Line | 401 NEW KARNER RD STE 301
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City | ALBANY
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State | NY
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Zip | 12205-3854
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Country | US
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Telephone | 838-200-6310
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Fax | 838-217-7320
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Provider Business Mailing Address
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Address Line | 401 NEW KARNER RD STE 301
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City | ALBANY
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State | NY
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Zip | 12205-3854
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Country | US
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Telephone | 838-200-6310
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | SP016689
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | F403907
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License Number State | NY
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