Individual
ATCHYUTA DEEPTHI VEGULLA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MBBS
Contact information
Practice address
585 SCHENECTADY AVE, BROOKLYN, NY 11203-1822
(718) 604-5401
Mailing address
87 RECTOR ST, MILLBURN, NJ 07041-1102
(309) 363-8704
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
U0869
TX
390200000X
Student in an Organized Health Care Education/Training Program
—
NY
Other
Enumeration date
04/29/2019
Last updated
06/10/2023
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