Provider Demographics
NPI:1295831881
Name:VEERAMACHANENI, USHA DEVI (MD)
Entity Type:Individual
Prefix:DR
First Name:USHA
Middle Name:DEVI
Last Name:VEERAMACHANENI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:USHA
Other - Middle Name:
Other - Last Name:DEVI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:24 PARKVIEW CIR
Mailing Address - Street 2:
Mailing Address - City:CARMEL
Mailing Address - State:NY
Mailing Address - Zip Code:10512-1827
Mailing Address - Country:US
Mailing Address - Phone:845-225-6404
Mailing Address - Fax:
Practice Address - Street 1:824 ROUTE 6
Practice Address - Street 2:DALMAX FORUM BLDG
Practice Address - City:MAHOPAC
Practice Address - State:NY
Practice Address - Zip Code:10541-1721
Practice Address - Country:US
Practice Address - Phone:845-628-3477
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY156524208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00822784Medicaid
NY00822784Medicaid