Provider Demographics
NPI:1699721803
Name:MUDALIAR, NIRMALA A (MD)
Entity type:Individual
Prefix:DR
First Name:NIRMALA
Middle Name:A
Last Name:MUDALIAR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:350 ALBERTA DRIVE
Mailing Address - Street 2:SUITE 207
Mailing Address - City:AMHERST
Mailing Address - State:NY
Mailing Address - Zip Code:14226
Mailing Address - Country:US
Mailing Address - Phone:716-204-9038
Mailing Address - Fax:716-836-1873
Practice Address - Street 1:350 ALBERTA DRIVE
Practice Address - Street 2:SUITE 207
Practice Address - City:AMHERST
Practice Address - State:NY
Practice Address - Zip Code:14226
Practice Address - Country:US
Practice Address - Phone:716-204-9038
Practice Address - Fax:716-836-1873
Is Sole Proprietor?:No
Enumeration Date:2006-05-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY113638207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology