Individual provider · NPI-1

Dr. Gauthami Reddy Churukanti, M.D.

Urology · Stony Brook, NY

NPI number1962763219
StatusActive
Last updated in NPPESApr 29, 2022

Details

NPI
1962763219
Entity type
Individual (NPI-1)
Name
Dr. Gauthami Reddy Churukanti
Credential
M.D.
Sex
Female
Sole proprietor
No
Enumeration date
Jun 4, 2012
Certification date
Apr 29, 2022
Last updated
Apr 29, 2022

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
208800000X UrologyMD460958PAYes
174400000X SpecialistMD460958PA

Practice location

101 Nicolls Rd # Hsct9040
Stony Brook, NY 11794-8265

Phone 631-444-2348

Mailing address

2350 Freedom Way Ste 102
York, PA 17402-8265

Phone 717-741-9536 · Fax 717-741-5509

Other practice locations

2350 Freedom Way Ste 102
York, PA 17402-8265

Phone 717-741-9536 · Fax 717-741-5509

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