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General NPI Number Information
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NPI Number | 1598288011
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Entity Type | Individual
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Provider Name | NAGA VENKATA DIVYA CHALLA
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Gender | Female
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Dates
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Enumeration Date | 07/18/2017
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Last Update Date | 08/14/2023
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Provider Practice Location Address
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Address Line | 400 TAYLOR RD
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City | MONTGOMERY
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State | AL
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Zip | 36117-3512
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Country | US
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Telephone | 334-747-4567
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Fax |
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Provider Business Mailing Address
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Address Line | ONE BROOKDALE PLAZA, 8 CHC ROOM 801-5 DEPARTMENT OF PEDIATRICS, BROOKDALE UNIVERSITY HOSPITAL
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City | BROOKLYN
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State | NY
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Zip | 11212
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Country | US
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Telephone | 718-240-5885
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Fax |
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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 | 2080N0001X
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Taxonomy Name | Neonatal-Perinatal Medicine Physician
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License Number | MD.46101
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License Number State | AL
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