Individual
CHANDANA GUDAVALLI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
31 NEW DORP LN, STATEN ISLAND, NY 10306-2351
(718) 979-5236
(718) 979-4466
Mailing address
981 US HIGHWAY 22 FL 2, BRIDGEWATER, NJ 08807-2946
(201) 801-7141
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
050052
NY
Other
Enumeration date
03/15/2023
Last updated
03/15/2023
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