Provider Demographics
NPI:1619932167
Name:GOLLAPALLI, SEKHAR (MD)
Entity Type:Individual
Prefix:
First Name:SEKHAR
Middle Name:
Last Name:GOLLAPALLI
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 1:497 TOWNLINE RD
Mailing Address - Street 2:
Mailing Address - City:HAUPPAUGE
Mailing Address - State:NY
Mailing Address - Zip Code:11788-2825
Mailing Address - Country:US
Mailing Address - Phone:631-724-2340
Mailing Address - Fax:631-724-2342
Practice Address - Street 1:497 TOWNLINE RD
Practice Address - Street 2:
Practice Address - City:HAUPPAUGE
Practice Address - State:NY
Practice Address - Zip Code:11788-2825
Practice Address - Country:US
Practice Address - Phone:631-724-2340
Practice Address - Fax:631-724-2342
Is Sole Proprietor?:No
Enumeration Date:2006-04-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY216950207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine