Doctor Name: | VENKATA SANDEEP KORIPALLI |
NPI Number: | 1013390723 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.D., |
License Number: | |
Business Practice Address: | 4422 3rd Ave Mills Building, Third Floor Bronx, NY - 104572545 |
Business Phone Number: | 3173246529 |
Business Fax Number: | |
Mailing Address: | 2491 Belmont Ave, Apt # 1f BRONX |
State: | NY |
Postal Code: | 104586229 |
Phone Number: | 3173246529 |
Fax Number: | |
NPI Enumeration Date: | 06/30/2015 |
NPI Last Update Date: | 06/30/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 390200000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Student, Health Care |
Taxonomy Classification: | Student in an Organized Health Care Education/Training Program |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |