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Individual
VASANTHA KONDAMUDI
Active
Individual
VASANTHA KONDAMUDI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
205727
NY
207Q00000X
Family Medicine Physician
Primary
25MA06681100
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01841556
—
NY
Enumeration date
08/04/2006
Last updated
04/11/2023
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