Basic Information
Provider Information
NPI: 1962405001
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: AMERNATH
FirstName: LINGAPPA
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 2004
Address2:  
City: EAST SYRACUSE
State: NY
PostalCode: 130574504
CountryCode: US
TelephoneNumber: 3153625285
FaxNumber: 3154452936
Practice Location
Address1: 1656 CHAMPLIN AVE
Address2:  
City: NEW HARTFORD
State: NY
PostalCode: 134131068
CountryCode: US
TelephoneNumber: 3156246222
FaxNumber: 3156246308
Other Information
ProviderEnumerationDate: 05/23/2005
LastUpdateDate: 04/26/2017
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207P00000X222315NYY Allopathic & Osteopathic PhysiciansEmergency Medicine 
207Q00000X222315NYN Allopathic & Osteopathic PhysiciansFamily Medicine 

No ID Information.


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