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Pavan Shankar Upadhyayula

Student in an Organized Health Care Education/Training Program in New York, NY. Individual provider (NPI-1).

NPI number1356920003
StatusActive
Last updated in NPPESApr 7, 2021

Details

NPI
1356920003
Entity type
Individual (NPI-1)
Name
Pavan Shankar Upadhyayula
Sex
Male
Sole proprietor
No
Enumeration date
Apr 7, 2021
Certification date
Apr 7, 2021
Last updated
Apr 7, 2021

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
390200000X Student in an Organized Health Care Education/Training Program–NYYes

Practice location

710 W 168th St
New York, NY 10032-3726

Phone 408-857-0418

Mailing address

710 W. 168th Street
Department Of Neurological Surgery, 4th Floor
New York, NY 10032

Phone 408-857-0418

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