MEDICARE: PRADEEP R. BANKULLA MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2085R0204X	Vascular & Interventional Radiology Physician	MD431933	PA
2	2085R0202X	Diagnostic Radiology Physician	MD431933	PA
3	2085R0204X	Vascular & Interventional Radiology Physician	25MA08298700	NJ
4	2085R0202X	Diagnostic Radiology Physician	25MA08298700	NJ

General Provider Information

NPI Number	:	1235171968
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PRADEEP R. BANKULLA MD

Provider Business Mailing Address
First Line	:	PO BOX 782743
Second Line	:	ATTN: CREDENTIALING
City	:	PHILADELPHIA
State	:	PA
Zip	:	19178-2743
Country	:	US
Telephone Number	:	602-910-6887
Fax Number	:	215-612-5077

Provider Business Practice Location Address
First Line	:	4900 FRANKFORD AVE
Second Line	:	ATTN: RADIOLOGY
City	:	PHILADELPHIA
State	:	PA
Zip	:	19124-2618
Country	:	US
Telephone Number	:	602-910-6887
Fax Number	:	215-612-5077

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/10/2006
Last Update Date	:	07/26/2019

Similar Medicare Providers

1760479216 — STEVEN S GREENSWEIG D.O.
Practice Location Address:

4900 FRANKFORD AVE , ATTN: RADIOLOGY
PHILADELPHIA, PA
19124-2618

Practice Phone: 215-612-2610
Practice Fax: 215-612-5077

1114906757 — MS. RITA A FOUST PA-C
Practice Location Address:

4900 FRANKFORD AVE
PHILADELPHIA, PA
19124-2618

Practice Phone: 215-831-2000
Practice Fax:

1740260371 — MARTIN LOUIS FRIEDMAN D.O.
Practice Location Address:

4900 FRANKFORD AVE , ATTN: RADIOLOGY
PHILADELPHIA, PA
19124-2618

Practice Phone: 215-612-2610
Practice Fax: 215-612-5077

1952371668 — BARRY NEIL SISKIND M.D.
Practice Location Address:

4900 FRANKFORD AVE , ATTN: RADIOLOGY
PHILADELPHIA, PA
19124-2618

Practice Phone: 215-612-2610
Practice Fax: 215-612-5077

1497795009 — CONSTANCE ORJI PAC
Practice Location Address:

4900 FRANKFORD AVE
PHILADELPHIA, PA
19124-2618

Practice Phone: 215-831-2000
Practice Fax:

1427085539 — E. ALEC SCHOENBERGER M.D.
Practice Location Address:

4900 FRANKFORD AVE , ATTN: RADIOLOGY
PHILADELPHIA, PA
19124-2618

Practice Phone: 215-612-2610
Practice Fax: 215-612-5077

Directions to “ PRADEEP R. BANKULLA MD” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.