Dr. Prabhavathi Gummalla M.D
Pediatric Pulmonology Physician in Philadelphia, PA(View on Map)
Full Name
Dr. Prabhavathi Gummalla M.D
NPI Number
1750700852
NPI Type
Individual Provider
Gender
Female
Enumeration Date
04/16/2014
Specialties
(Taxonomies)Code
2080P0214X
2080S0012X
Primary Taxonomy
Yes
No
Licenses
State
New Jersey
New York
Pennsylvania
License Number
25MA10793600
285065
MD458931
Contact
Information
Purpose
Mailing
Location
Address
2-10 LINDEN AVE
3401 CIVIC CENTER BLVD
City
Haddonfield
Philadelphia
State
NJ
PA
Postal Code
08033-2556
19104-4319
Country
US
US
Telephone Number
(917) 715-5360
(917) 715-5360
Provider data last refreshed from NPPES NPI registry on 11/19/2024
Data last updated by provider on 02/09/2023
Provider Address
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