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1376228239
SHIVSAI GONGALLA
PHILADELPHIA, PA
NPI
1376228239
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
2084P0800X Psychiatry & Neurology, Psychiatry
(Licence: PA MT229487)
Enumeration Date
2023-06-19
Last Update Date
2023-06-19
Business Address
Dr. SHIVSAI GONGALLA MD
100 E LEHIGH AVE UNIT N238
PHILADELPHIA, PA 19125-1012
Phone number: 215-707-1200
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Mailing Address
Dr. SHIVSAI GONGALLA MD
1050 N HANCOCK ST # N238
PHILADELPHIA, PA 19123-2342
Phone number:
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