Individual
JERRY PUDUSSERI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
1800 MULBERRY ST, SCRANTON, PA 18510-2369
(570) 703-4830
(570) 703-4835
Mailing address
100 N ACADEMY AVE, DANVILLE, PA 17822-4903
(570) 703-4830
(570) 703-4835
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
2724241
NY
207RA0001X
Advanced Heart Failure and Transplant Cardiology Physician
Primary
OS025564
PA
207RC0000X
Cardiovascular Disease Physician
Primary
2724241
NY
Other
Enumeration date
04/28/2011
Last updated
02/20/2026
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