Provider Demographics
NPI:1396257531
Name:DOPPALAPUDI, SAI KRISHNA (MD)
Entity type:Individual
Prefix:MR
First Name:SAI
Middle Name:KRISHNA
Last Name:DOPPALAPUDI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1650 SELWYN AVENUE
Mailing Address - Street 2:#10C
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10457
Mailing Address - Country:US
Mailing Address - Phone:718-590-1800
Mailing Address - Fax:718-960-2055
Practice Address - Street 1:1650 SELWYN AVENUE
Practice Address - Street 2:#10C
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10457
Practice Address - Country:US
Practice Address - Phone:718-590-1800
Practice Address - Fax:718-960-2055
Is Sole Proprietor?:No
Enumeration Date:2017-10-27
Last Update Date:2020-11-25
Deactivation Date:2018-06-05
Deactivation Code:
Reactivation Date:2020-11-25
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program