Individual
PRAVEENA GANDIKOTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
ONE MEDICAL CENTER BLVD, SUITE 424, UPLAND, PA 19013
(610) 338-1820
(610) 338-1825
Mailing address
ONE MEDICAL CENTER BLVD, SUITE 424, UPLAND, PA 19013
(610) 338-1820
(610) 338-1825
Taxonomy
Speciality
Code
Description
License number
State
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
MD440569
PA
390200000X
Student in an Organized Health Care Education/Training Program
MT 185538
PA
Other
Enumeration date
05/11/2007
Last updated
10/29/2012
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