Mangala Puttanniah, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

140415 Issued in NY

Practice address

91 Chenango Bridge Rd
Binghamton, NY 13901-1293

Phone

(607) 648-6667

Fax

(607) 648-4141

NPI assigned

Aug 2, 2005

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1122940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1321660800000",
    "number": "1780685693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "346 GRAND AVE",
            "city": "JOHNSON CITY",
            "state": "NY",
            "postal_code": "137902558",
            "telephone_number": "607-770-0025",
            "fax_number": "607-729-3982"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "91 CHENANGO BRIDGE RD",
            "city": "BINGHAMTON",
            "state": "NY",
            "postal_code": "139011293",
            "telephone_number": "607-648-6667",
            "fax_number": "607-648-4141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PUTTANNIAH",
        "first_name": "MANGALA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-02",
        "last_updated": "2011-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "140415",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00435465",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jason C. Purdy, LCSW
• Michelle May Purdy, RPH
• Talitha Purdy, PT
• Mary Purvis
• Krishna M Putcha, DO
• Hammad Qadri
• Mavra Qaiser
• Guanming Qi, MD, PHD
• Katie Ann Quackenbush, RN
• Mohammad A Quasem, MD

• Pediatrics Physician in Binghamton, NY
• Providers in Binghamton, NY by specialty
• Pediatrics Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.