Individual
DR. SRISATISH DEVAPATLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D., FAAP
Contact information
Practice address
101 DATES DR, ITHACA, NY 14850-1342
(607) 274-4496
(607) 274-4232
Mailing address
605 CAYUGA HEIGHTS RD, ITHACA, NY 14850-1423
(607) 319-4320
(607) 274-4232
Taxonomy
Speciality
Code
Description
License number
State
2080N0001X
Neonatal-Perinatal Medicine Physician
Primary
001544
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001544
—
NY
05
—
06000001544
—
NY
Enumeration date
01/29/2007
Last updated
07/09/2007
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