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General NPI Number Information
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NPI Number | 1952340887
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Entity Type | Individual
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Provider Name | MOHAN VODAPALLY M.D.,DABPM
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Gender | Male
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Dates
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Enumeration Date | 06/06/2006
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Last Update Date | 02/04/2020
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Provider Practice Location Address
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Address Line | 2447 WHITNEY AVE, SUITE 1
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City | HAMDEN
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State | CT
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Zip | 06511-3211
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Country | US
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Telephone | 203-624-4400
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Fax | 203-624-4402
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Provider Business Mailing Address
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Address Line | 2447 WHITNEY AVE, SUITE1
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City | HAMDEN
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State | CT
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Zip | 06518-3211
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Country | US
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Telephone | 203-624-4400
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Fax | 203-624-4402
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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 | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 039595
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License Number State | CT
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Taxonomy #2
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Taxonomy Code | 208VP0014X
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Taxonomy Name | Interventional Pain Medicine Physician
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License Number | 039595
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License Number State | CT
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