Dr. Prabhavathi Gummalla, MD
Pediatrics, Pediatric Pulmonology in Philadelphia, Pennsylvania
1750700852- Practice location
- 3401 Civic Center Blvd, Philadelphia, PA 19104-4319
- Phone
- 917-715-5360
- Fax
- —
- Last updated
- February 9, 2023
Prabhavathi Gummalla is a Pediatrics, Pediatric Pulmonology based in Philadelphia, PA. Prabhavathi Gummalla practices in Philadelphia, PA and has the professional credentials of MD. The NPI Number for Prabhavathi Gummalla is 1750700852 and holds a License No. 25MA10793600 (NJ). The current practice location address for Prabhavathi Gummalla is 3401 Civic Center Blvd, Philadelphia, PA 19104-4319 and can be reached out via phone at 917-715-5360.
Provider Profile Details
- NPI Number
- 1750700852
- Provider Name
- Prabhavathi Gummalla
- Credential
- MD
- Provider Entity Type
- Individual
- Gender
- Female
- Address
- 3401 Civic Center Blvd, Philadelphia, PA 19104-4319
- Phone Number
- 917-715-5360
- Primary Taxonomy
- Pediatrics, Pediatric Pulmonology · 2080P0214X
- Sole Proprietor
- Yes
- Provider Enumeration Date
- April 16, 2014
- Last Update Date
- February 9, 2023
- Certification Date
- February 9, 2023
- NPI Status
- Active
Provider Business Practice Location Address Details
- Address
- 3401 Civic Center Blvd
Philadelphia, PA 19104-4319 - City
- Philadelphia
- State
- Pennsylvania
- Zip
- 19104-4319
- Phone Number
- 917-715-5360
Provider Business Mailing Address Details
- Address
- 2-10 Linden Ave
Haddonfield, NJ 08033-2556 - City
- Haddonfield
- State
- NJ
- Zip
- 08033-2556
- Phone Number
- 917-715-5360
License Information
- License Number (1)
- 25MA10793600
- License State (1)
- NJ
- Taxonomy (1)
- Pediatrics, Pediatric Pulmonology · 2080P0214X
- License Number (2)
- 285065
- License State (2)
- NY
- Taxonomy (2)
- Pediatrics, Pediatric Pulmonology · 2080P0214X
- License Number (3)
- MD458931
- License State (3)
- PA
- Taxonomy (3)
- Pediatrics, Sleep Medicine · 2080S0012X
- License Number (4)
- 25MA10793600
- License State (4)
- NJ
- Taxonomy (4)
- Pediatrics, Sleep Medicine · 2080S0012X
- License Number (5)
- MD458931
- License State (5)
- PA
- Taxonomy (5)
- Pediatrics, Pediatric Pulmonology · 2080P0214X · Primary
Legacy Identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| No legacy identifiers (Medicaid, Medicare or plan IDs) are on file for this provider. | |||
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- Aigner J Allen, MSPsychologist, Clinical · NPI 1710697677
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Frequently Asked Questions
What is the NPI number of Dr. Prabhavathi Gummalla, MD?
The NPI number of Dr. Prabhavathi Gummalla, MD is 1750700852. It was assigned on April 16, 2014 and is currently active in the NPPES registry.
What is the specialty of Dr. Prabhavathi Gummalla, MD?
Dr. Prabhavathi Gummalla, MD is registered under the primary taxonomy Pediatrics, Pediatric Pulmonology (code 2080P0214X), licensed in NJ under license number 25MA10793600.
Where does Dr. Prabhavathi Gummalla, MD practice?
The practice location is 3401 Civic Center Blvd, Philadelphia, PA 19104-4319. The office can be reached at 917-715-5360 (phone).
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). It is used in HIPAA standard transactions.
How do I verify this NPI record?
This record is sourced from the public NPPES NPI Registry maintained by CMS. You can confirm it by searching NPI 1750700852 directly on the NPPES registry website.