Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207U00000X | Nuclear Medicine Specialist | 043712 | CT |
Y | 207U00000X | Nuclear Medicine Specialist | 230974-01 | NY |
NPI | 1780667113 |
---|---|
Provider Name | Dr. Indukala Doddamane |
First Address | Cheshire, CT 06410-1991 |
Second Address | Bronx, NY 10461-1138 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/11/2005 |
Last Update Date | 09/10/2019 |