Provider Demographics
NPI:1063294304
Name:JAMADAGNI, PRACHI (BS, MS)
Entity type:Individual
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First Name:PRACHI
Middle Name:
Last Name:JAMADAGNI
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Gender:F
Credentials:BS, MS
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Mailing Address - Street 1:71 BLUE JAY WAY
Mailing Address - Street 2:
Mailing Address - City:REXFORD
Mailing Address - State:NY
Mailing Address - Zip Code:12148
Mailing Address - Country:US
Mailing Address - Phone:518-930-1987
Mailing Address - Fax:
Practice Address - Street 1:71 BLUE JAY WAY
Practice Address - Street 2:
Practice Address - City:REXFORD
Practice Address - State:NY
Practice Address - Zip Code:12148
Practice Address - Country:US
Practice Address - Phone:518-930-1987
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-20
Last Update Date:2023-10-20
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant