Individual
RUBY POTTUKALAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1648 HUNTINGDON PIKE, MEADOWBROOK, PA 19046-8001
(215) 938-2100
Mailing address
1648 HUNTINGDON PIKE, MEDICAL STAFF OFFICE FIRST FLOOR, MEADOWBROOK, PA 19046-8001
(215) 938-3450
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
MA057714
PA
363AM0700X
Medical Physician Assistant
OA003584
PA
Other
Enumeration date
11/05/2015
Last updated
09/25/2017
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