Provider Demographics
NPI:1235585407
Name:KANNEGANTI, AVANI GAYATHRI (MD)
Entity Type:Individual
Prefix:
First Name:AVANI GAYATHRI
Middle Name:
Last Name:KANNEGANTI
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 1:3898 VINEYARD DR STE 1
Mailing Address - Street 2:
Mailing Address - City:DUNKIRK
Mailing Address - State:NY
Mailing Address - Zip Code:14048-3559
Mailing Address - Country:US
Mailing Address - Phone:716-898-4226
Mailing Address - Fax:716-898-3279
Practice Address - Street 1:3898 VINEYARD DR STE 1
Practice Address - Street 2:
Practice Address - City:DUNKIRK
Practice Address - State:NY
Practice Address - Zip Code:14048-3559
Practice Address - Country:US
Practice Address - Phone:716-363-6960
Practice Address - Fax:716-203-7386
Is Sole Proprietor?:No
Enumeration Date:2016-05-06
Last Update Date:2019-10-25
Deactivation Date:2016-12-30
Deactivation Code:
Reactivation Date:2018-05-17
Provider Licenses
StateLicense IDTaxonomies
NY300697207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine