Provider Demographics
NPI:1851551584
Name:MANCHIKALAPUDI, RAMA BINDU (MD)
Entity Type:Individual
Prefix:
First Name:RAMA BINDU
Middle Name:
Last Name:MANCHIKALAPUDI
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 1:172 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON
Mailing Address - State:NY
Mailing Address - Zip Code:11743-2948
Mailing Address - Country:US
Mailing Address - Phone:631-385-0022
Mailing Address - Fax:631-385-0896
Practice Address - Street 1:161 E MAIN ST
Practice Address - Street 2:
Practice Address - City:HUNTINGTON
Practice Address - State:NY
Practice Address - Zip Code:11743-2967
Practice Address - Country:US
Practice Address - Phone:631-385-0022
Practice Address - Fax:631-385-0896
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-16
Last Update Date:2022-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY281545207RC0000X, 207RA0001X
NY301139207RA0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Multi-Specialty
No207RA0001XAllopathic & Osteopathic PhysiciansInternal MedicineAdvanced Heart Failure and Transplant CardiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03796486Medicaid
OHP01358008OtherRAILROAD MEDICARE - MHCPI
WV3810028206Medicaid
OH0104842Medicaid
WV3810028206Medicaid