Individual
DEEPTHI KAGOLANU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2201 HEMPSTEAD TPKE, EAST MEADOW, NY 11554-1859
(949) 981-8781
Mailing address
2201 HEMPSTEAD TPKE, EAST MEADOW, NY 11554-1859
(516) 296-3349
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
61951
CT
207R00000X
Internal Medicine Physician
DR.0070217
CO
207RG0100X
Gastroenterology Physician
DR.0070217
CO
Other
Enumeration date
04/04/2015
Last updated
03/30/2023
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