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DR. PRABHAVATHI GUMMALLA M.D NPI 1750700852


NPI Information

NPI: 1750700852
Provider Name: DR. PRABHAVATHI GUMMALLA, M.D
Classification: Pediatrics - 2080P0214X
Entity Type: Individual

Specialization: Pediatric Pulmonology

PECOS Registration: Yes

Address:
3401 CIVIC CENTER BLVD
PHILADELPHIA, PA
ZIP 19104
Phone: (917) 715-5360
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DR. Prabhavathi Gummalla, M.D is a pediatric pulmonology pediatrics in Philadelphia, PA. The provider is a pediatrician dedicated to the prevention and treatment of all respiratory diseases affecting infants, children and young adults. This specialist is knowledgeable about the growth and development of the lung, assessment of respiratory function in infants and children, and experienced in a variety of invasive and noninvasive diagnostic techniques. DR. Prabhavathi Gummalla, M.D NPI is 1750700852. The provider is registered as an individual entity type and is a multi-specialty group.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

3401 CIVIC CENTER BLVD
PHILADELPHIA, PA
ZIP 19104-319
Phone: (917) 715-5360

The NPI 1750700852 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 4/16/2014 and was last updated on 2/9/2023.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
12080P0214XPediatricsPediatric Pulmonology25MA10793600NEW JERSEYNo
22080P0214XPediatricsPediatric Pulmonology285065NEW YORKNo
32080S0012XPediatricsSleep MedicineMD458931PENNSYLVANIANo
42080S0012XPediatricsSleep Medicine25MA10793600NEW JERSEYNo
52080P0214XPediatricsPediatric PulmonologyMD458931PENNSYLVANIAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.