MEDICARE: DR. SATYANARAYAN AVULA 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	173000000X	Legal Medicine	131633	NY

General Provider Information

NPI Number	:	1285609024
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SATYANARAYAN AVULA MD

Provider Business Mailing Address
First Line	:	1285 RICHMOND AVE
Second Line	:
City	:	STATEN ISLAND
State	:	NY
Zip	:	10314-1562
Country	:	US
Telephone Number	:	718-370-3020
Fax Number	:	718-494-3566

Provider Business Practice Location Address
First Line	:	1285 RICHMOND AVE
Second Line	:
City	:	STATEN ISLAND
State	:	NY
Zip	:	10314-1562
Country	:	US
Telephone Number	:	718-370-3020
Fax Number	:	718-494-3566

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

Provider Enumeration Date	:	02/22/2006
Last Update Date	:	01/04/2011

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