Provider Demographics
NPI:1619297256
Name:VALLURU, RAMA (MD,)
Entity type:Individual
Prefix:DR
First Name:RAMA
Middle Name:
Last Name:VALLURU
Suffix:
Gender:F
Credentials:MD,
Other - Prefix:DR
Other - First Name:RAMA
Other - Middle Name:
Other - Last Name:VALLURU
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:413 SAGAMORE AVE
Mailing Address - Street 2:
Mailing Address - City:EAST WILLISTON
Mailing Address - State:NY
Mailing Address - Zip Code:11596-2427
Mailing Address - Country:US
Mailing Address - Phone:516-742-2144
Mailing Address - Fax:516-742-2144
Practice Address - Street 1:413 SAGAMORE AVE
Practice Address - Street 2:
Practice Address - City:EAST WILLISTON
Practice Address - State:NY
Practice Address - Zip Code:11596-2427
Practice Address - Country:US
Practice Address - Phone:516-742-2144
Practice Address - Fax:516-742-2144
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-05
Last Update Date:2010-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY185054208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics