Individual
DR. NERAVANDA K MEDAPPA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
8662 BAY PKWY, BROOKLYN, NY 11214-4102
(718) 714-6489
Mailing address
65 MEDFORD RD, STATEN ISLAND, NY 10304-3217
(718) 273-4367
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
111428
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00200404
—
NY
Enumeration date
10/17/2006
Last updated
07/08/2007
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