Provider Demographics
NPI:1538504998
Name:KORAPATI, SUNITHA (MD)
Entity Type:Individual
Prefix:
First Name:SUNITHA
Middle Name:
Last Name:KORAPATI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 HAMILTON ST
Mailing Address - Street 2:
Mailing Address - City:DOBBS FERRY
Mailing Address - State:NY
Mailing Address - Zip Code:10522-2862
Mailing Address - Country:US
Mailing Address - Phone:914-202-2944
Mailing Address - Fax:
Practice Address - Street 1:30 HAMILTON ST
Practice Address - Street 2:
Practice Address - City:DOBBS FERRY
Practice Address - State:NY
Practice Address - Zip Code:10522-2862
Practice Address - Country:US
Practice Address - Phone:914-202-2944
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-30
Last Update Date:2019-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY290792207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAVVM497AMedicare PIN
VA531844YWAUMedicare PIN