Individual
DR. RENUKA BANKULLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
212 GAIR ST, PIERMONT, NY 10968-1058
(914) 434-0329
Mailing address
212 GAIR ST, PIERMONT, NY 10968-1058
(914) 434-0329
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
209451
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01801192
—
NY
Enumeration date
11/28/2005
Last updated
07/07/2016
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