Provider Demographics
NPI:1982140554
Name:SATCHIDANAND, ANTARA (MA)
Entity Type:Individual
Prefix:MS
First Name:ANTARA
Middle Name:
Last Name:SATCHIDANAND
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:258 GRIMSBY RD
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14223-1921
Mailing Address - Country:US
Mailing Address - Phone:716-544-9904
Mailing Address - Fax:
Practice Address - Street 1:6490 TAYLOR RD LOT 17
Practice Address - Street 2:
Practice Address - City:HAMBURG
Practice Address - State:NY
Practice Address - Zip Code:14075-6565
Practice Address - Country:US
Practice Address - Phone:877-246-2396
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-01-06
Last Update Date:2017-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program