Manjula Muddappa, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

208320 Issued in NY

Practice address

3 Tech Valley Dr
East Greenbush, NY 12061-4134

Phone

(518) 441-1250

NPI assigned

Jan 31, 2006

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)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1138665600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560297600000",
    "number": "1861463523",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 TECH VALLEY DR",
            "city": "EAST GREENBUSH",
            "state": "NY",
            "postal_code": "120614134",
            "telephone_number": "518-441-1250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 TECH VALLEY DR",
            "city": "EAST GREENBUSH",
            "state": "NY",
            "postal_code": "120614134",
            "telephone_number": "518-441-1250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUDDAPPA",
        "first_name": "MANJULA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-31",
        "last_updated": "2019-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "208320",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01852299",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Margaret Momot-Baker, PH.D
• Lylah Morone
• Catherine Ann Morrow, M.S.C.C.C.-S.L.P.
• Gary Lee Moscowitz, D.D.S.
• Dave Mosley, LMT
• Meghan Katherine Mulone
• Salamata Nacro
• Latchmi Narayan
• Krista Marie Nelson
• Kayleigh Newhouse

• Internal Medicine Physician in East Greenbush, NY
• Providers in East Greenbush, NY by specialty
• Internal Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2019; 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.