Gummalla, Prabhavathi
Gummalla, Prabhavathi is an sole proprietor health care provider with primary practice located at 3401 Civic Center Blvd , Philadelphia PA 19104-4319. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pediatric Pulmonology, Allopathic & Osteopathic Physicians / Sleep Medicine. Allopathic & Osteopathic Physicians / Pediatric Pulmonology is her primary health care specialty. Gummalla, Prabhavathi can be contacted via phone (917) 715-5360.Contact Information
Primary practice address
3401 Civic Center Blvd
Philadelphia PA 19104-4319
Phone: (917) 715-5360
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatric Pulmonology | 2080P0214X | 25MA10793600 | New Jersey |
| Allopathic & Osteopathic Physicians / Pediatric Pulmonology | 2080P0214X | 285065 | New York |
| Allopathic & Osteopathic Physicians / Sleep Medicine | 2080S0012X | MD458931 | Pennsylvania |
| Allopathic & Osteopathic Physicians / Sleep Medicine | 2080S0012X | 25MA10793600 | New Jersey |
| Allopathic & Osteopathic Physicians / Pediatric Pulmonology | 2080P0214X | MD458931 | Pennsylvania |
Profile Details
| NPI number | 1750700852 |
|---|---|
| LBN Legal business name | Gummalla, Prabhavathi |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Apr 16th, 2014 |
| Last updated | Feb 9th, 2023 - about last year |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
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