Provider Demographics
NPI:1588452858
Name:BONDUGULA, VASANTHI
Entity type:Individual
Prefix:
First Name:VASANTHI
Middle Name:
Last Name:BONDUGULA
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 UNIVERSITY BLVD STE B
Mailing Address - Street 2:
Mailing Address - City:HARRISONBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22801-3969
Mailing Address - Country:US
Mailing Address - Phone:540-214-3732
Mailing Address - Fax:
Practice Address - Street 1:20 UNIVERSITY BLVD STE B
Practice Address - Street 2:
Practice Address - City:HARRISONBURG
Practice Address - State:VA
Practice Address - Zip Code:22801-3969
Practice Address - Country:US
Practice Address - Phone:540-214-3732
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-28
Last Update Date:2025-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program