Provider Demographics
NPI:1043872666
Name:VEGUNTA, RATHNAMITREYEE (MD)
Entity Type:Individual
Prefix:
First Name:RATHNAMITREYEE
Middle Name:
Last Name:VEGUNTA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 WOODS ROAD
Mailing Address - Street 2:TAYLOR PAVILION,D 322
Mailing Address - City:VALHALLA
Mailing Address - State:NY
Mailing Address - Zip Code:10595
Mailing Address - Country:US
Mailing Address - Phone:914-493-6610
Mailing Address - Fax:
Practice Address - Street 1:100 WOODS ROAD
Practice Address - Street 2:TAYLOR PAVILION,D 322
Practice Address - City:VALHALLA
Practice Address - State:NY
Practice Address - Zip Code:10595
Practice Address - Country:US
Practice Address - Phone:914-493-6610
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-03
Last Update Date:2019-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program