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General NPI Number Information
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NPI Number | 1407839368
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Entity Type | Individual
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Provider Name | SAILAJA MUSUNURI MD
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Gender | Female
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Dates
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Enumeration Date | 11/23/2005
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Last Update Date | 08/04/2025
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Provider Practice Location Address
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Address Line | 8TH AVENUE & HAY RD KIDSPEACE NATIONAL CENTERS BERKS CAMPUS
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City | TEMPLE
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State | PA
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Zip | 19560
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Country | US
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Telephone | 610-929-4670
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Fax | 610-929-4686
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Provider Business Mailing Address
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Address Line | 527 DUBLIN DRIVE
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City | DOWNINGTON
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State | PA
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Zip | 19335
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Country | US
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Telephone | 484-432-1857
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Fax | 610-594-2561
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 25MA11355800
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 2084P0804X
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Taxonomy Name | Child & Adolescent Psychiatry Physician
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License Number | 25MA11355800
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License Number State | NJ
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Taxonomy #3
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Taxonomy Code | 2084P0804X
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Taxonomy Name | Child & Adolescent Psychiatry Physician
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License Number | MD072136L
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License Number State | PA
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