Individual
SRIVALLI ISUKAPALLI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1177 SUMMER ST FL 5, STAMFORD, CT 06905-5522
(203) 353-1133
(203) 653-3398
Mailing address
1290 SILAS DEANE HIGHWAY, HHC-CVO, WETHERSFIELD, CT 06109-4337
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
06/22/2023
Last updated
09/11/2023
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