Individual
DR. SASI KIRAN PENUKONDA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
261269
MA
2080P0205X
Pediatric Endocrinology Physician
Primary
325077
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110103822A
—
MA
Enumeration date
09/08/2009
Last updated
01/09/2023
Update your record
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