Individual
GNANAMBA V KONDAGUNTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
155 CRYSTAL RUN RD, MIDDLETOWN, NY 10941-4028
(845) 703-6999
(845) 703-6297
Mailing address
155 CRYSTAL RUN RD, MIDDLETOWN, NY 10941-4028
(845) 703-6999
(845) 703-6297
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
215626
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03067865
—
NY
Enumeration date
01/29/2006
Last updated
10/07/2020
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