Individual
MS. SANGHAMITRA KODUKULA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN, BSN, MSN
Contact information
Practice address
1275 YORK AVE, NEW YORK, NY 10065-6007
(212) 639-6840
Mailing address
1275 YORK AVE, NEW YORK, NY 10065-6007
Taxonomy
Speciality
Code
Description
License number
State
163WN0800X
Neuroscience Registered Nurse
551691
NY
367500000X
Certified Registered Nurse Anesthetist
Primary
551691
NY
Other
Enumeration date
07/29/2010
Last updated
12/17/2024
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