Provider Demographics
NPI:1275589897
Name:JYOTHI KAMAL GELLA, MD, FACP, INC.
Entity Type:Organization
Organization Name:JYOTHI KAMAL GELLA, MD, FACP, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JYOTHI
Authorized Official - Middle Name:
Authorized Official - Last Name:GELLA, MD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:814-539-8715
Mailing Address - Street 1:600 FRANKLIN ST
Mailing Address - Street 2:
Mailing Address - City:JOHNSTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:15901-2630
Mailing Address - Country:US
Mailing Address - Phone:814-539-8715
Mailing Address - Fax:814-539-4026
Practice Address - Street 1:600 FRANKLIN ST
Practice Address - Street 2:
Practice Address - City:JOHNSTOWN
Practice Address - State:PA
Practice Address - Zip Code:15901-2630
Practice Address - Country:US
Practice Address - Phone:814-539-8715
Practice Address - Fax:814-539-4026
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-25
Last Update Date:2012-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA090933Medicare ID - Type Unspecified