Individual
SOUMYA BOLLAMPALLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
200 BOWMAN DR STE E385 BACK, VOORHEES, NJ 08043-9638
(856) 840-4534
(856) 762-2853
Mailing address
301 LIPPINCOTT DR STE 410, MARLTON, NJ 08053-4197
(856) 355-0340
(856) 355-0330
Taxonomy
Speciality
Code
Description
License number
State
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
OS017602
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0497061
—
NJ
Enumeration date
06/10/2010
Last updated
11/08/2024
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