Individual
PADMAJA JONNALAGADDA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3401 N BROAD STREET, PHILADELPHIA, PA 19140-1702
(215) 707-7237
(217) 707-7237
Mailing address
2450 W HUNTING PARK AVE, PHILADELPHIA, PA 19129-1302
(215) 707-7237
(215) 707-9389
Taxonomy
Speciality
Code
Description
License number
State
2085N0904X
Nuclear Radiology Physician
Primary
MD429986
PA
2085R0202X
Diagnostic Radiology Physician
35.088719
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2760892
—
OH
01
—
P00396884
RAILROAD MEDICARE
OH
01
—
P00423243
RAILROAD MEDICARE
OH
Enumeration date
08/08/2006
Last updated
09/11/2018
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