Provider Demographics
NPI:1447208160
Name:DUVVI, KAMALAMMA A (MD)
Entity Type:Individual
Prefix:DR
First Name:KAMALAMMA
Middle Name:A
Last Name:DUVVI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:35 WILLIAM PUCKEY DR
Mailing Address - Street 2:
Mailing Address - City:CORTLANDT MANOR
Mailing Address - State:NY
Mailing Address - Zip Code:10567-6215
Mailing Address - Country:US
Mailing Address - Phone:914-737-6861
Mailing Address - Fax:914-737-6861
Practice Address - Street 1:2094 ALBANY POST RD
Practice Address - Street 2:VA HVHCS
Practice Address - City:MONTROSE
Practice Address - State:NY
Practice Address - Zip Code:10548-1454
Practice Address - Country:US
Practice Address - Phone:914-737-4400
Practice Address - Fax:914-788-4304
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1322022084P0805X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0805XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyGeriatric Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02712834Medicaid
NY02712834Medicaid
NY62M261Medicare ID - Type Unspecified