Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RG0300X | Geriatric Medicine | 253123 | NY |
NPI | 1164755294 |
---|---|
Provider Name | Dr. Rani L Gundavarapu |
First Address | Bronx, NY 10461-1138 |
Second Address | Bronx, NY 10461-1138 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/09/2009 |
Last Update Date | 16/07/2010 |