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General NPI Number Information
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NPI Number | 1497788442
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Entity Type | Individual
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Provider Name | DHAMAVARAPU PRAMILA MD
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Gender | Female
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Dates
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Enumeration Date | 07/09/2006
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Last Update Date | 04/15/2009
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Provider Practice Location Address
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Address Line | 240 WILLOUGHBY ST SUITE 11E
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City | BROOKLYN
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State | NY
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Zip | 11201-5465
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Country | US
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Telephone | 718-250-8866
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Fax | 718-250-6703
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Provider Business Mailing Address
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Address Line | 30 PURITAN AVE
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City | FOREST HILLS
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State | NY
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Zip | 11375-6029
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Country | US
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Telephone | 718-263-7970
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Fax | 718-250-8864
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number | 119606
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License Number State | NY
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