Individual
DR. LALITHA V GUMIDYALA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD, MPH
Contact information
Practice address
1770 BATHGATE RD, SUITE #200, BETHLEHEM, PA 18017
(484) 884-2249
(484) 884-7053
Mailing address
3195 MILAN STREET, EASTON, PA 18045
(732) 512-7895
(484) 884-7053
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
MD475971
PA
2083X0100X
Occupational Medicine Physician
Primary
MD475971
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0088668
—
NJ
01
—
01007800901
AMERICHOICE
NJ
01
—
305282
AMERIGROUP
NJ
Enumeration date
01/27/2006
Last updated
02/11/2022
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