Provider Demographics
NPI:1922532381
Name:MANEPALLI, ASHOK KUMAR
Entity Type:Individual
Prefix:DR
First Name:ASHOK KUMAR
Middle Name:
Last Name:MANEPALLI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:77 GOODELL ST
Mailing Address - Street 2:SUITE 5
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14203-1243
Mailing Address - Country:US
Mailing Address - Phone:716-829-6104
Mailing Address - Fax:716-829-3640
Practice Address - Street 1:77 GOODELL ST
Practice Address - Street 2:SUITE 5
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14203-1243
Practice Address - Country:US
Practice Address - Phone:716-829-6104
Practice Address - Fax:716-829-3640
Is Sole Proprietor?:No
Enumeration Date:2017-04-12
Last Update Date:2022-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
NY317695207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program