DR. PRABHAVATHI GUMMALLA M.D NPI 1750700852

NPI Information

  • NPI: 1750700852
  • Provider Name: DR. PRABHAVATHI GUMMALLA, M.D
  • Classification: Pediatrics - 2080P0214X
  • Specialization: Pediatric Pulmonology
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 3401 CIVIC CENTER BLVD
    PHILADELPHIA, PA
    ZIP 19104
  • Phone: (917) 715-5360

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NPI Details

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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
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: 3/30/2025

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