Provider Demographics
NPI:1114981909
Name:GADDIPATI, SWARUPA RANI (MD)
Entity Type:Individual
Prefix:DR
First Name:SWARUPA
Middle Name:RANI
Last Name:GADDIPATI
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:24 STRATFORD DR
Mailing Address - Street 2:
Mailing Address - City:SOMERSET
Mailing Address - State:NJ
Mailing Address - Zip Code:08873-4824
Mailing Address - Country:US
Mailing Address - Phone:732-873-9556
Mailing Address - Fax:732-873-9556
Practice Address - Street 1:1225 GERARD AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10452-8001
Practice Address - Country:US
Practice Address - Phone:718-960-2894
Practice Address - Fax:718-960-7037
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-17
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY151045207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYF85158Medicare UPIN