Provider Demographics
NPI:1245591833
Name:POLAVARAPU, APARNA VENKATA RAMARAO (MD)
Entity Type:Individual
Prefix:DR
First Name:APARNA
Middle Name:VENKATA RAMARAO
Last Name:POLAVARAPU
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:APARNA
Other - Middle Name:VENKATA
Other - Last Name:RAMARAO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1408 N HARRISON ST
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19806-3114
Mailing Address - Country:US
Mailing Address - Phone:315-256-4456
Mailing Address - Fax:
Practice Address - Street 1:111 E 210TH ST
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10467-2401
Practice Address - Country:US
Practice Address - Phone:718-430-2447
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-05-31
Last Update Date:2020-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA104619002084N0402X
NY303528-012084N0402X
PAMT201826208000000X
DEC1-00129642084N0402X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0402XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology with Special Qualifications in Child Neurology
No208000000XAllopathic & Osteopathic PhysiciansPediatrics