Basic Information
| Provider Information | |||||||||
| NPI: | 1578003430 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | AKULA | ||||||||
| FirstName: | SHILPA | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 327 BEACH 19TH ST | ||||||||
| Address2: | |||||||||
| City: | FAR ROCKAWAY | ||||||||
| State: | NY | ||||||||
| PostalCode: | 116914423 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7188697000 | ||||||||
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| Practice Location | |||||||||
| Address1: | 200 MADISON AVE FL 3 | ||||||||
| Address2: | |||||||||
| City: | ELMIRA | ||||||||
| State: | NY | ||||||||
| PostalCode: | 149013219 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6077341581 | ||||||||
| FaxNumber: | 6077340972 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/26/2017 | ||||||||
| LastUpdateDate: | 09/29/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 09/29/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 308804 | NY | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.