Individual
DR. GAUTHAMI REDDY CHURUKANTI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
101 NICOLLS RD # HSCT9040, STONY BROOK, NY 11794-8265
(631) 444-2348
Mailing address
2350 FREEDOM WAY STE 102, YORK, PA 17402-8265
(717) 741-9536
(717) 741-5509
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
MD460958
PA
208800000X
Urology Physician
Primary
MD460958
PA
Other
Enumeration date
06/04/2012
Last updated
04/29/2022
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