Provider Demographics
NPI:1386825214
Name:AMARANATHA, LAKYA ANANTHARAMAIAH (MD)
Entity Type:Individual
Prefix:
First Name:LAKYA
Middle Name:ANANTHARAMAIAH
Last Name:AMARANATHA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1128 RURAL RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:CHESWICK
Mailing Address - State:PA
Mailing Address - Zip Code:15024
Mailing Address - Country:US
Mailing Address - Phone:412-421-9366
Mailing Address - Fax:
Practice Address - Street 1:1128 RURAL RIDGE DR
Practice Address - Street 2:
Practice Address - City:CHESWICK
Practice Address - State:PA
Practice Address - Zip Code:15024-2438
Practice Address - Country:US
Practice Address - Phone:412-421-9366
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-20
Last Update Date:2007-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD432735207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine