Provider Demographics
NPI:1437438264
Name:KONDAPALLI, SRINIVAS SAI A (MD)
Entity Type:Individual
Prefix:DR
First Name:SRINIVAS
Middle Name:SAI A
Last Name:KONDAPALLI
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 1:1835 FORBES AVE
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15219-5835
Mailing Address - Country:US
Mailing Address - Phone:412-288-0885
Mailing Address - Fax:412-281-1926
Practice Address - Street 1:1835 FORBES AVE
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15219-5835
Practice Address - Country:US
Practice Address - Phone:412-288-0885
Practice Address - Fax:412-281-1926
Is Sole Proprietor?:No
Enumeration Date:2011-08-10
Last Update Date:2016-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35125713207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0140956Medicaid
OHP01626999OtherRAILROAD MEDICARE
OHP01626999OtherRAILROAD MEDICARE